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.
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.
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
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
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.
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.
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.
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.
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.
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:
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.
Following these guidelines will help ensure that your application process goes smoothly and efficiently.
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:
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.
Here are key takeaways for filling out and using the ANCC Certification Verification form: