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The Ancc Certification Verification form, central to the validation process of APRN education, plays a pivotal role in ensuring the credentials of aspiring Advanced Practice Registered Nurses (APRNs) are thoroughly vetted and recognized. This comprehensive document requires meticulous attention from both the candidate and their program director. The candidate is responsible for furnishing personal and educational specifics including any other legal names used, contact information, and details relating to their nursing program such as the degree type, the number of faculty-supervised patient care clinical hours, and the anticipated completion date. Program directors, on the other hand, are tasked with verifying the accuracy of the coursework and clinical experiences listed, affirming the program’s accreditation status, and providing details on the program’s focus, such as whether it targets family nursing practice, adult-gerontology, or another specialization. Additionally, specific content areas must be confirmed, such as health promotion, disease management, and advanced pharmacology, with particular attention paid to psychiatric mental health nurse practitioner (PMHNP) candidates, who must also document psychotherapeutic treatment modalities. The form can be submitted in hard copy or electronically, necessitating a signature from the program director to validate its contents. This meticulous validation process underscores the commitment of the ANCC towards upholding high standards in nursing education and practice, embodying the dedication to excellence in professional development and credentials within the nursing community.

Preview - Ancc Certification Verification Form

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

Download Ancc Certification Verification PDF Form

Form Data

Fact Name Description
Form Purpose The Validation of APRN Education Form is used to confirm the candidate's educational preparation in an Advanced Practice Registered Nurse (APRN) program.
Submission Options The completed form can be submitted as a hard copy, signed electronically and emailed, or mailed to the ANCC.
Program Director's Role The Program Director must complete the majority of this form, verifying the candidate's coursework and clinical hours.
Candidate Requirements Candidates must have completed all required APRN didactic courses and faculty-supervised, direct patient care clinical hours.
Accreditation The form requires information on the accreditation status of the program completed, with options including ACEN, CCNE, and CNEA.
Statement of Understanding A section for faculty use only where the individual attests the accuracy and completeness of the information provided on the candidate's behalf.

Instructions on Utilizing Ancc Certification Verification

Filling out the ANCC Certification Verification form is a crucial step in the certification process for APRN (Advanced Practice Registered Nurse) candidates. This form is designed to validate the educational background of the candidate by corroborating the information with the APRN program director. It ensures that all required didactic courses and clinical hours have been successfully completed. Once the form is filled out and submitted, it marks the advancement of the candidate towards achieving certification, a significant milestone in their nursing career. Below are the step-by-step instructions to accurately complete the form.

  1. Start by entering the candidate's information in the designated "Candidate Information Section". This includes the candidate's last name, first name, middle initial (MI), any other legal names used, email address, and residential address (city, state, zip/postal code).
  2. The candidate then passes the form to the program director of their APRN program to fill out the rest.
  3. The program director should enter the name of the university, city, state, their name, phone number, and email in the "Program Information" section.
  4. In the "Candidate Educational Preparation" section, the program director must specify the population and role of the program completed (e.g., Family Nurse Practitioner, Adult-Gerontology CNS), and the degree type (Master’s, DNP, Post-Master’s Certificate, or Post-Master’s DNP).
  5. If the candidate is enrolled in a Post-Graduate program, document and submit credit granted for prior courses/clinical hours accepted from previous programs via gap analysis or a signed statement on school letterhead.
  6. Enter the date of (anticipated) completion and the number of faculty-supervised direct patient care clinical hours.
  7. Indicate whether the student has completed all required APRN didactic courses/faculty supervised, direct patient care clinical hours required for program completion.
  8. Select the accreditation body of the program completed at the time of clinician’s graduation and enter the expiration date.
  9. For dual programs, specify the role and populations of the programs and attach a detailed description of the content and clinical hours for each role and population on letterhead and sign the attachment.
  10. Under the coursework section, specify whether the content in Health Promotion/Disease Prevention, Differential Diagnosis/Disease Management, Advanced Physical/Health Assessment, Advanced Pathophysiology, and Advanced Pharmacology was covered. For PMHNP clinicians, also indicate if content in at least 2 psychotherapeutic treatment modalities was covered.
  11. In the "Statement of Understanding" section, the program director must print their name, insert their title, and the program name to attest the truth and accuracy of the information provided. They must then sign and date the form.
  12. Lastly, choose the preferred method of submission: hard copy to be returned to the candidate, signed electronically and emailed to APRNValidation@ana.org, or mailed to the provided ANCC address.

After completing these steps, the form should be submitted through one of the specified methods. Submission of this form is critical in moving forward with the certification process. It allows the ANCC to verify the candidate's educational qualifications and is one of the final steps before the candidate is eligible to sit for the certification examination. Accurate and prompt submission of this form facilitates a smoother certification process for the candidate.

Obtain Answers on Ancc Certification Verification

  1. What is the purpose of the ANCC Certification Verification form?
    The ANCC Certification Verification form, also recognized as the Validation of APRN Education Form, is instrumental for APRN candidates. Its primary purpose is to authenticate the educational preparation and qualifications of candidates seeking advanced practice registered nurse (APRN) certification. By filling out this form, candidates can officially verify that they have completed all necessary coursework and clinical hours as per their APRN program's requirements. This step is crucial for ensuring that the candidate is eligible to sit for the certification examination and for maintaining the integrity and high standards of the nursing profession.

  2. How should the form be completed and submitted?
    To complete the form accurately, the candidate must fill out the Candidate Information Section and then pass it to their Program Director. The Program Director is responsible for entering the detailed course numbers and verifying the completion of all required fields, including documentation for any post-graduate program specifics. Once filled, the form can be submitted in three ways: as a hard copy signed by the Program Director to be forwarded to ANCC by the candidate, signed electronically and e-mailed directly to APRNValidation@ana.org, or mailed to the ANCC’s provided address. Timely and proper submission of this form is vital for the application process.

  3. What information is required from the Program Director?
    Program Directors play a critical role in the verification process. They must verify the candidate’s completion of the APRN program, including specific details such as the population and role of the program completed, the degree type, the number of faculty-supervised direct patient care clinical hours, program accreditation at the time of the clinician’s graduation, along with any dual program details if applicable. Furthermore, they are also required to provide a statement of understanding, affirming the accuracy and completeness of the submitted information, and sign the form to validate its contents.

  4. What happens if the form is submitted without a signature?
    If the Validation of APRN Education Form is submitted without the required Program Director’s signature, the processing of the candidate’s application encounters a delay. This delay can further postpone the review of the candidate’s application and their ability to take the certification examination. Securing the necessary signature is a cornerstone requirement for the validation process, ensuring that the information provided is verified and endorsed by the educational institution.

  5. Can the ANCC request additional information after the form is submitted?
    Yes, the American Nurses Credentialing Center (ANCC) reserves the right to request more detailed accounting of the coursework and program completed by the candidate. The ANCC may also contact faculty directly if there are any questions or clarifications needed upon review of the transcripts or any other submitted documentation. This step ensures the thorough examination and confirmation of the candidate’s educational qualifications and compliance with certification standards.

Common mistakes

Filling out the ANCC Certification Verification form accurately is crucial for the progress and validation of one's advanced practice nursing education and subsequent certification. However, certain mistakes can hinder this process, leading to delays or complications in achieving certification. Below are seven common errors encountered:

  1. **Incomplete Candidate Information**: Candidates often omit filling in essential details in the Candidate Information Section, such as not listing all legal names used, which can cause issues if the names do not correspond with other legal documents.

  2. **Omission of Course Numbers**: Program Directors sometimes forget to include specific course numbers when detailing the candidate's course completion history. This error can lead to ambiguities about the exact courses completed.

  3. **Ignoring the Requirement for Hard Copies**: Some individuals overlook the option or requirement to submit a hard copy of the form, properly signed, and instead opt only for electronic submission without ensuring it includes a verified digital signature.

  4. **Forgetting to Document Credit for Previous Programs**: When it comes to Post-Master’s Certificate or DNP programs, there's a crucial step of documenting and submitting credit granted for prior coursework/clinical hours through Gap Analysis, which is often overlooked.

  5. **Neglecting to Specify Dual Programs Properly**: If engaged in a dual program, failing to clearly specify the roles and populations for each program, along with forgetting to attach the detailed description required, can result in processing delays.

  6. **Inadequate Detail on Course Content**: Particularly for PMHNP clinicians, there's a requirement to affirm content coverage in at least two psychotherapeutic treatment modalities. Lack of clarity or confirmation on these specifics can be problematic.

  7. **Signature Omissions**: Both candidates and program directors sometimes miss the crucial step of signing the document, a lapse that inevitably leads to processing delays since a signature attests to the veracity of the information provided.

Beyond these mistakes, here are several proactive steps one can take to ensure smooth processing:

  • Double-Check All Filled Sections: Before submission, review each section carefully to ensure completeness and accuracy.

  • Verify Electronic Signatures: If submitting electronically, make sure the digital signature is legally recognized and validated.

  • Maintain Open Communication with the Program Director: Candidates should ensure they collaborate closely with their program directors to avoid missing out on essential details or documents.

By avoiding these common mistakes and following these steps, candidates can facilitate a smoother certification process, moving them closer to achieving their professional credentials without unnecessary delay.

Documents used along the form

When pursuing certification through the American Nurses Credentialing Center (ANCC), professionals often need to submit several key documents alongside the ANCC Certification Verification Form to establish their qualifications comprehensively. These documents play a vital role in the certification process by providing detailed insights into the candidate's educational background, practical experience, and personal identification. Understanding each document's purpose can streamline the certification journey, ensuring a smoother verification process.

  • Professional Resume or Curriculum Vitae (CV): This document outlines the healthcare professional's educational background, work experience, certifications, honors, and publications. It's pivotal for showcasing the breadth of the candidate's expertise and experience in the nursing field.
  • Official Transcripts: Transcripts from accredited institutions detail the courses completed by the candidate, grades earned, and degree(s) conferred. These are crucial for verifying the educational achievements and ensuring they meet the ANCC's requirements.
  • Proof of Current RN License: A copy of the candidate's current registered nurse (RN) license validates their legal authorization to practice nursing. It must be current and in good standing for the certification to proceed.
  • Continuing Education Certificates: Documents proving completion of continuing education (CE) courses are necessary for certain certifications. These certificates affirm that the candidate has engaged in ongoing learning and professional development pertinent to their specialty.

In conclusion, while the ANCC Certification Verification Form is the focal point of the application, its companions – the Professional Resume or CV, Official Transcripts, Proof of Current RN License, and Continuing Education Certificates – are equally crucial. Together, they paint a comprehensive picture of the candidate’s credentials, paving the way for a successful certification. Paying due attention to the preparation and submission of these documents can significantly facilitate the certification process.

Similar forms

  • Medical Credentialing Application Forms: Similar to the ANCC Certification Verification form, Medical Credentialing Application forms are essential in confirming a healthcare provider's qualifications, education, and training to ensure they meet the necessary standards. Both forms require detailed information about the candidate's educational background, specific courses completed, and verification from an authoritative figure, such as a Program Director.

  • Professional Licensure Application Forms: These forms, necessary for various professions, share similarities with the ANCC Certification Verification form in their purpose to validate the qualifications and educational accolades of applicants. They often require detailed educational history, proof of completed coursework, and certification from educational program directors or similar authorities to ensure the applicant meets the specific licensure criteria.

  • Nurse Practitioner Protocol Agreement Forms: These agreements outline the scope of practice for nurse practitioners within specific settings and are similar to the ANCC form in that they require detailed verification of the nurse practitioner's qualifications, including education and certifications. Both forms play crucial roles in establishing the competency and authority of the nurse practitioner to deliver healthcare services.

  • Educational Transcript Request Forms: Much like the Verification of APRN Education form, Transcript Request forms are used to obtain official records of a student’s academic performance. Both require accurate and comprehensive reporting of coursework and, at times, specific details about the program completed to verify the candidate's educational background for certifying bodies or educational institutions.

  • Continuing Education (CE) Verification Forms: These forms are used by professionals to verify completion of continuing education requirements for licensure renewal or certification maintenance. Similar to the ANCC form, CE Verification forms help ensure that the individual has met required educational standards, proving competency in their field through additional coursework or training.

  • Course Exemption or Transfer Credit Request Forms: Students submit these forms to request exemption from certain coursework or transfer credit from previous educational experiences, akin to the ANCC Certification Verification form which involves documenting and submitting credit granted for prior courses or clinical hours. Both types of documents necessitate detailed educational information and approvals to alter the traditional educational or certification pathways based on past achievements.

Dos and Don'ts

Filling out the ANCC Certification Verification form is a crucial step in your journey towards becoming a certified Advanced Practice Registered Nurse (APRN). To ensure a smooth process, it’s important to understand what you should and shouldn't do. Here are tips to guide you:

Things You Should Do
  1. Double-check Candidate Information: Make sure all personal information is correct, including spelling of your name, email address, and any other legal names used. This ensures that all communications and certifications are accurately attributed to you.
  2. Complete the Candidate Educational Preparation Accurately: It’s crucial to accurately report your educational preparation, including the type of degree, the role of your program (e.g., Family Nurse Practitioner), and your completion date. Also, accurately report the number of faculty-supervised direct patient care clinical hours completed.
  3. Provide Accurate Program Information: Ensure the name of the university, the program director’s name and contact information, and the program accreditation are accurately filled in. This will aid in the seamless verification of your educational credentials.
  4. Sign and Submit the Form Correctly: Whether you are submitting a hard copy or sending it electronically, ensure that the form is signed as required. Unsigned forms will delay the process.

Things You Shouldn't Do
  • Avoid Guesswork: When entering course numbers and titles, especially under the ‘Content’ sections like Advanced Physical/Health Assessment, Advanced Pathophysiology, and Advanced Pharmacology, do not guess. Ensure the information matches your official transcripts and coursework exactly.
  • Do Not Leave Sections Incomplete: Make sure every required field is filled out. Leaving sections blank can result in delays in processing your verification form.
  • Refrain from Submitting Unverified Information: Verify all the information with your program director before submission, especially the sections that need to be filled out or signed by them. Incorrect information can cause unnecessary delays.
  • Avoid Submitting Without Review: Before submitting the form, review each section carefully to ensure all information is accurate and complete. This can save time by preventing back-and-forth due to errors or omissions.

By following these dos and don'ts, you can navigate the ANCC Certification Verification form process more smoothly, avoiding common pitfalls and setting the stage for a successful certification process.

Misconceptions

There are several misconceptions surrounding the ANCC Certification Verification form that merit clarification to ensure candidates and program directors navigate the process effectively. Here are four common misunderstandings:

  • Electronic Submission is the Only Option: While the form can be signed electronically and emailed to APRNValidation@ana.org, this is not the only method of submission. Hard copies can also be sent back to the candidate for forwarding to ANCC or mailed directly to the ANCC’s Certification Registration office.
  • Only Current Coursework Needs to be Documented: It's a common belief that only the courses currently being completed by the candidate need to be listed. However, the form requires documentation of all APRN didactic courses and faculty-supervised direct patient care clinical hours required for program completion, including those credited from previous programs through a Gap Analysis or a signed statement.
  • All Programs Are Accredited Equally: The form differentiates between various accreditations, such as ACEN, CCNE, and CNEA. It’s crucial to specify the accreditation relevant to the time of the clinician’s graduation. The mistaken belief that all types of accreditation are viewed equally could mislead when verifying a program's legitimacy and quality.
  • Statement of Understanding is Optional: There might be an assumption that the "Statement of Understanding" is a formality and not a requirement. This section, however, must be completed by the program director, asserting their authority to verify the candidate's information. Submission without this signature can delay the processing and review of a candidate's application.

Addressing these misconceptions is essential for ensuring the smooth completion and submission of the ANCC Certification Verification form, thereby aiding in the accurate validation of a candidate’s APRN education and facilitating a more efficient certification process.

Key takeaways

Filling out and using the ANCC Certification Verification form is an essential step for obtaining advanced practice registered nurse (APRN) certification. Here are five key takeaways to ensure the process goes smoothly:

  • Complete Candidate Information Accurately: The candidate must fill out their section with accurate and complete information. This includes legal names, contact details, and any other requested personal information. Ensuring all details are correct at this stage prevents any delays or issues with the verification process.
  • Program Director Involvement: The form requires specific details about the candidate's educational preparation, including course numbers, types of degrees, and accreditation of the program. The program director must provide this information, so involving them early and providing clear instructions is key.
  • Submission Options: The completed and signed form can be submitted in several ways - as a hard copy returned to the candidate to forward to the ANCC, signed electronically and emailed directly, or mailed to the ANCC's address. Each option has its own process, so choosing the most convenient and reliable method is crucial.
  • Attention to Required Fields: Every section and field in the form must be filled out comprehensively. Incomplete forms can result in processing delays. Pay special attention to sections that require detailed educational and clinical experience information, ensuring it accurately reflects the candidate's completed coursework and clinical hours.
  • Understanding and Agreement: The program director must sign the form to attest to the accuracy and completeness of the information provided. This signifies an understanding and agreement that the details are correct and verifiable. Unsigned forms lead to delays, underscoring the importance of this step in the verification process.

These takeaways highlight the importance of attention to detail, accurate and comprehensive information, and the necessary involvement of both the candidate and the program director in the ANCC Certification Verification form process. Following these guidelines will help ensure a smooth and efficient certification process for APRN candidates.

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