Get Ancc Certification Verification Form

Get Ancc Certification Verification Form

The Ancc Certification Verification form is a crucial document that confirms the educational background and qualifications of Advanced Practice Registered Nurse (APRN) candidates. This form must be completed by both the candidate and their program director, ensuring all necessary information about the candidate's education and clinical hours is accurately documented. To get started, fill out the form by clicking the button below.

Structure

The ANCC Certification Verification Form is a critical document for candidates seeking certification as Advanced Practice Registered Nurses (APRNs). This form requires candidates to provide their personal information, including their name, email address, and educational background. It is essential that the Program Director completes the form, detailing the candidate's coursework and clinical hours. Accurate course numbers and titles must be included, reflecting the actual courses the candidate has completed. Candidates must ensure all required fields are filled out before submission. The form can be submitted in three ways: as a hard copy that is signed and returned to the candidate, electronically signed and emailed, or mailed directly to the American Nurses Credentialing Center (ANCC). Additionally, the form includes sections for the candidate's educational preparation, including the type of degree obtained and the accreditation of the program. A statement of understanding must be signed by the Program Director to confirm the accuracy of the information provided. This verification process is essential for timely processing and review of the candidate's application for certification.

Ancc Certification Verification Preview

Validation of APRN

Education Form

CANDIDATE Please fill in the Candidate Information Section of this form and give it to the Program Director to complete the balance of the form and sign.

PROGRAM DIRECTOR When entering course numbers, please include the actual courses the Candidate completed. Please fill in all required fields and submit as follows:

Hard copy, signed, and returned to the candidate to be forwarded to ANCC

OR, signed electronically and e-mailed to APRNValidation@ana.org

OR, mailed to:

American Nurses Credentialing Center (ANCC)

Attn: Certification Registration

8515 Georgia Avenue, Suite 400

Silver Spring, MD 20910

CPM-FRM-51 | Validation of APRN Education Form | May 2020­

Validation of APRN Education Form

CANDIDATE INFORMATION

 

Applicant Last Name

First Name

MI

 

 

 

 

 

Other Legal Names Used

Email

 

 

 

 

 

 

Address

City

State Zip/Postal

 

 

 

 

PROGRAM INFORMATION

 

 

 

 

 

 

Name of University

City

State

 

 

 

 

 

Program Director Name­

Program Director Phone Number

Program Director Email

 

 

 

 

CANDIDATE EDUCATIONAL PREPARATION

 

 

 

 

Population and Role of Program Completed (e.g., Family Nurse Practitioner, Adult-Gerontology CNS)

 

Degree Type: Master’s

DNP Post-Master’s Certificate*

Post-Master’s DNP*

*If a Post-Graduate program, school must document and submit credit granted for prior courses/clinical hours accepted from previous program(s) via Gap Analysis and/or signed statement on school letterhead.

Date of (Anticipated) Completion

Number of Faculty-Supervised Direct, Patient Care Clinical Hours­

Has the student completed all required APRN didactic courses/faculty supervised, direct patient care clinical hours, required for program

completion? Yes No

Accreditation of Program Completed (at time of clinician’s graduation): ACEN CCNE

CNEA Exp Date: _________

Dual Program? Yes* No

*If yes, specify the role and populations of the programs in the box above and attach a detailed description of the content and clinical hours for each role and population. Use letterhead and sign the attachment.

Content in:

Health Promotion/Disease Prevention Content

Differential Diagnosis/Disease Management Content

Yes

No

Course Number

Title

Advanced Physical/Health Assessment

Advanced Pathophysiology

Advanced Pharmacology

For PMHNP clinicians ONLY

Content in at least 2 psychotherapeutic treatment modalities Yes No

STATEMENT OF UNDERSTANDING • FOR FACULTY USE ONLY

I, ___________________________________________, ____________________________________________ of the

insert nameinsert title

_____________________________________________________________, attest that I am duly authorized by the above school to

insert program name

confirm the information provided in this Validation of APRN Education Form (“Form”) to be true, accurate, and complete, and reflect only the coursework and clinical hours actually completed by the Candidate for Certification identified above (the “Candidate”).

(Forms received without a signature incur a delay in processing, which will cause a delay in the review of the Candidate’s application and ability to take a certification examination.)

Required Program Director Signature

Print Name

Date

ANCC reserves the right to request a more detailed accounting of coursework/program completed. ANCC reserves the right to contact the faculty with questions upon review of transcript(s), etc.

CPM-FRM-51 | Validation of APRN Education Form | May 2020

Document Data

Fact Name Description
Purpose of the Form The ANCC Certification Verification form is designed to validate the educational preparation of Advanced Practice Registered Nurses (APRNs) seeking certification.
Candidate Responsibilities Candidates must fill out their personal information and submit the form to their Program Director for completion and signature.
Program Director's Role The Program Director must provide accurate course details and confirm that the candidate has met all educational requirements.
Submission Methods The completed form can be submitted as a hard copy, electronically signed and emailed, or mailed directly to the ANCC.
Required Information The form requires detailed information about the candidate's education, including program accreditation and clinical hours completed.
State-Specific Requirements Each state may have specific governing laws regarding APRN certification; candidates should verify local requirements before submission.
Importance of Accuracy Accuracy in the completion of this form is critical, as any discrepancies can delay the certification process for the candidate.

How to Use Ancc Certification Verification

Completing the ANCC Certification Verification form is a crucial step in the certification process for Advanced Practice Registered Nurses (APRNs). It requires attention to detail and accurate information from both the candidate and the program director. After filling out the necessary sections, the form must be submitted through one of the specified methods to ensure timely processing.

  1. Begin by filling out the Candidate Information section. Include your last name, first name, middle initial, any other legal names used, email address, city, state, and zip/postal code.
  2. Next, move on to the Program Information section. Provide the name of your university, the city and state where it is located, the program director's name, phone number, and email address.
  3. In the Candidate Educational Preparation section, specify the population and role of the program you completed (e.g., Family Nurse Practitioner). Indicate your degree type, whether it’s a Master’s, DNP, Post-Master’s Certificate, or Post-Master’s DNP. If applicable, include information about prior courses or clinical hours accepted.
  4. Fill in the Date of (Anticipated) Completion and the number of faculty-supervised direct patient care clinical hours you have completed.
  5. Answer the question regarding whether you have completed all required APRN didactic courses and clinical hours for program completion by selecting Yes or No.
  6. Indicate the Accreditation of Program Completed at the time of graduation by selecting from ACEN, CCNE, or CNEA. Enter the expiration date if applicable.
  7. Specify whether you completed a dual program by selecting Yes or No. If yes, provide details about the roles and populations of the programs and attach a signed letterhead description.
  8. Complete the content sections related to Health Promotion/Disease Prevention and Differential Diagnosis/Disease Management by selecting Yes or No for each.
  9. For PMHNP clinicians, confirm if you have completed content in at least two psychotherapeutic treatment modalities by selecting Yes or No.
  10. In the Statement of Understanding section, the program director must print their name, title, and sign the form to confirm the accuracy of the information provided.
  11. Finally, submit the completed form as a hard copy signed and returned to you, electronically signed and emailed to APRNValidation@ana.org, or mailed to the ANCC at the specified address.

Key Facts about Ancc Certification Verification

What is the purpose of the ANCC Certification Verification form?

The ANCC Certification Verification form is designed to confirm that a candidate has completed the necessary educational requirements to qualify for advanced practice registered nurse (APRN) certification. It ensures that the candidate's academic program meets the standards set by the American Nurses Credentialing Center (ANCC) and verifies the completion of required coursework and clinical hours.

Who needs to fill out the ANCC Certification Verification form?

The form must be filled out by both the candidate and the program director. The candidate provides their personal information, while the program director verifies the educational details and signs the form to confirm its accuracy.

How should the completed form be submitted?

The completed form can be submitted in several ways: it can be sent as a hard copy, signed and returned to the candidate for forwarding to ANCC; it can be signed electronically and emailed to APRNValidation@ana.org; or it can be mailed directly to the ANCC at their Silver Spring, MD address. It's important to follow the submission guidelines to avoid delays.

What information is required from the candidate?

The candidate must provide their last name, first name, middle initial, any other legal names used, email address, city, state, and zip/postal code. Additionally, they must specify their educational program, degree type, anticipated completion date, and confirm whether they have completed all required courses and clinical hours.

What details must the program director include?

The program director needs to fill in the university name, city, state, their name, phone number, and email address. They must also provide specific course numbers, titles, and confirm the accreditation status of the program. If the candidate is in a dual program, the director must specify the roles and populations involved and provide detailed descriptions of the coursework and clinical hours.

What happens if the form is not signed?

If the form is submitted without a signature from the program director, it will incur a delay in processing. This can affect the candidate's application review and their ability to take the certification examination. Therefore, it is crucial that the form is signed before submission.

Are there any additional requirements for candidates in dual programs?

Yes, candidates in dual programs must provide a detailed description of the content and clinical hours for each role and population. This information should be attached to the form on official letterhead and signed to ensure authenticity.

What should candidates do if they have questions about the form?

If candidates have questions or need clarification regarding the form, they should reach out to their program director or contact the ANCC directly. It’s important to have all the necessary information before submitting the form to avoid any complications in the certification process.

Common mistakes

Filling out the ANCC Certification Verification form can be a straightforward process, but several common mistakes can lead to delays or complications. Understanding these pitfalls can help ensure a smoother certification journey.

One frequent mistake is failing to complete all required fields in the Candidate Information section. Each piece of information is crucial for proper identification and processing. Omitting details such as the candidate’s last name or email address can lead to significant delays. Always double-check that every section is filled out completely before submitting the form.

Another common error involves the Program Director's section. Sometimes, candidates do not ensure that the Program Director has accurately entered course numbers and titles. This section must reflect the exact courses completed by the candidate. If the information is incorrect or incomplete, it may result in the ANCC needing to contact the school for clarification, which can slow down the entire process.

It’s also essential to submit the form in the correct format. Some candidates mistakenly think that an electronic signature suffices when a hard copy is required. Ensure that the form is either signed and returned as a hard copy or signed electronically and emailed to the appropriate address. Not adhering to these submission guidelines can lead to processing delays.

Another mistake involves the documentation of clinical hours. Candidates sometimes fail to provide the necessary details about their faculty-supervised direct patient care clinical hours. This information is critical for the ANCC to verify that the candidate has met the program's requirements. Be sure to include the total number of hours and confirm that all required courses have been completed.

Additionally, candidates often overlook the importance of the Statement of Understanding section. This section requires a signature from the Program Director. Submitting the form without this signature can cause significant delays. Always ensure that the Program Director has reviewed and signed the form before submission.

Finally, candidates sometimes forget to include any necessary attachments. If the program is a dual program, it’s crucial to attach a detailed description of the content and clinical hours for each role and population. Not providing this documentation can lead to confusion and additional requests for information from the ANCC.

By being aware of these common mistakes and taking the time to review the form thoroughly, candidates can help ensure a smoother and more efficient certification process.

Documents used along the form

The ANCC Certification Verification form is a crucial document for candidates seeking certification as Advanced Practice Registered Nurses (APRNs). Along with this form, several other documents are often required to ensure a comprehensive verification of the candidate's qualifications and educational background. Below are some commonly used forms and documents that may accompany the ANCC Certification Verification form.

  • Official Transcript: This document provides a detailed record of the candidate's academic performance, including courses taken, grades received, and the degree conferred. It must be sent directly from the educational institution to maintain its authenticity.
  • Gap Analysis Report: If a candidate has completed a post-graduate program, this report outlines any credits granted for prior courses or clinical hours accepted from previous programs. It helps clarify how prior education meets current certification requirements.
  • Clinical Hours Documentation: This document verifies the number of faculty-supervised, direct patient care clinical hours completed by the candidate. It is essential for demonstrating that the candidate has met the practical experience requirements for certification.
  • Program Accreditation Verification: This form confirms that the educational program attended by the candidate is accredited by recognized bodies such as ACEN or CCNE. Accreditation status is critical for ensuring the quality and recognition of the candidate's education.
  • Statement of Understanding: This statement is completed by the Program Director, confirming the accuracy of the information provided in the Validation of APRN Education Form. It serves as an official endorsement of the candidate's educational qualifications.

Submitting these documents along with the ANCC Certification Verification form helps streamline the certification process. Ensuring that all required paperwork is complete and accurate can significantly reduce processing delays and facilitate a smoother transition into certification.

Similar forms

The ANCC Certification Verification form shares similarities with several other documents used in the credentialing and educational verification processes. Below are five documents that exhibit comparable functions and structures:

  • Verification of Employment Form: This document confirms an individual's employment history and qualifications. Like the ANCC form, it requires signatures from authorized personnel and often includes detailed information about the candidate's roles and responsibilities during their tenure.
  • Official Transcript: An official transcript provides a comprehensive record of a candidate's academic performance. Similar to the ANCC form, it must be issued by an educational institution and often requires verification by the program director or registrar to ensure accuracy.
  • Clinical Hours Documentation Form: This form details the clinical hours completed by a candidate during their training. It parallels the ANCC form in that it requires specific information about the clinical experience and must be signed by a supervising faculty member or program director.
  • Certification Application Form: This document is used to apply for certification in a specific field. It resembles the ANCC form in its requirement for personal and educational information, as well as supporting signatures from relevant authorities to validate the candidate's qualifications.
  • Continuing Education Verification Form: This form verifies the completion of required continuing education credits. Like the ANCC form, it includes details about the courses taken, the provider's information, and necessitates verification from an accredited institution or organization.

Dos and Don'ts

When filling out the ANCC Certification Verification form, attention to detail is crucial. Here are some important dos and don'ts to keep in mind.

  • Do fill in all required fields accurately to avoid processing delays.
  • Do provide your Program Director with the form promptly for completion.
  • Do ensure that the Program Director includes actual course numbers and titles.
  • Do confirm that all required clinical hours and courses are completed before submission.
  • Don't leave any sections blank; incomplete forms may be rejected.
  • Don't forget to sign the form if submitting a hard copy; unsigned forms will cause delays.
  • Don't submit the form electronically without verifying that all information is correct.
  • Don't ignore the submission guidelines; follow the specified methods to ensure timely processing.

Following these guidelines will help ensure that your application process goes smoothly and efficiently.

Misconceptions

Understanding the ANCC Certification Verification form is crucial for candidates seeking certification. However, there are several misconceptions that can lead to confusion and delays. Here are four common misconceptions:

  • It can be submitted without a signature. Some candidates believe that they can submit the form without a Program Director's signature. This is not true. A signature is essential, as forms without it will face processing delays.
  • Only hard copies are accepted. Many assume that only hard copies of the form are valid. In reality, the form can also be signed electronically and emailed to the designated ANCC address, or mailed directly to the ANCC office.
  • All fields are optional. There is a misconception that not all fields need to be filled out. However, every required field must be completed to ensure a smooth processing of the application. Missing information can lead to significant delays.
  • Any program accreditation is acceptable. Some candidates think that any accreditation is sufficient. However, the program must be accredited by recognized bodies such as ACEN, CCNE, or CNEA at the time of graduation to meet ANCC requirements.

Being aware of these misconceptions can help candidates navigate the certification process more effectively. Ensure that all information is accurate and complete to avoid unnecessary delays in your application.

Key takeaways

Here are key takeaways for filling out and using the ANCC Certification Verification form:

  • The form requires candidates to provide their personal information, including last name, first name, and email address.
  • Candidates must submit the form to their Program Director for completion and signature.
  • Program Directors need to include actual course numbers and titles that the candidate completed.
  • All required fields must be filled out to avoid processing delays.
  • Completed forms can be submitted as a hard copy, electronically, or via mail to the ANCC.
  • Ensure the form is signed by the Program Director; unsigned forms will delay processing.
  • Include details about the candidate’s educational preparation, such as degree type and completion date.
  • Accreditation status of the program must be indicated, along with its expiration date.
  • If applicable, specify if the candidate is enrolled in a dual program and provide additional documentation.
  • Be aware that ANCC may request further details regarding coursework and may contact faculty for verification.