Sample Advanced Pte Board Certification Letter Template


Advanced PTE Board Certification
For Physicians who completed 12 month clinical fellowship dedicated to the
perioperative care of surgical patients with cardiovascular disease
(Requirements 4 and 5)
National Board of Echocardiography, Inc.
1500 Sunday Drive, Suite 102
Raleigh, NC 27607
Physician’s Full Name
Physician’s Date of Birth
Physician’s Social Security Number (last 4 digits)
ACGME Program Number
To Whom It May Concern:
This letter further confirms that Dr. ____(name)_____ successfully completed a minimum of 12 months of clinical fellowship training
dedicated to the perioperative care of surgical patients with cardiovascular disease at our institution between ___(beginning date)___
and ___(ending date)____. This letter further confirms that fellowship training was obtained at an institution with an affiliation with
an accredited core residency program.
Our records indicate that __(he/she)__ had specific training in Perioperative Transesophageal Echocardiography and personally
performed, interpreted, and reported ___(#)____ comprehensive intraoperative TEE examinations under appropriate supervision. In
addition, ___(he/she)___ studied under appropriate supervision, but did not perform ____(#)___ studies for a total of ___(#)____
complete intraoperative TEE examinations. These studies include a wide spectrum of cardiac diagnoses.
I certify that the number of studies provided above are exact numbers and are not rounded and/or estimates.
Notary Seal
Title (Residency Program Director, Fellowship Training Director, etc.)
Sworn and subscribed to before me on (date): ___________________________
Signature of Notary Public
NOTE: *The EXACT number of studies performed and interpreted MUST be provided. Applications containing
approximated and/or rounded numbers will no longer be reviewed by the Certification Committee. Letters MUST be on
appropriate letterhead and MUST be notarized


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