Trainer’s signature: _______________________________
IBHC’s signature: _______________________________
Date:_____________________
Phase II Training
Successful completion requires all items (shaded and unshaded) rated as “Pass”
CIRCLE: PASS / FAIL - (Provide rationale in comments.) Date of completion: ___________________
Trainer’s signature: _______________________________
IBHC’s signature: _______________________________
Date:_____________________
COMMENTS:
14
