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ACM Examination Application

Complete this form ONLY if you are a first time test candidate.

If you are requesting a retest, you must first log into your ACM account by clicking here.

NOTE: All initial examinations must be scheduled and confirmed for a date within three (3) months following approval of this application.

Upon submission, candidates will receive a scheduling notice from the testing provide, PSI/AMP, and will be directed to schedule their examination through the AMP Candidate Services online portal, or by contacting PSI/AMP by phone or email.

Referred By?

Were you referred to get certified by a member, chapter, or partner company? If so, enter their name or referral code below.

Candidate Information

*First Name:
 Middle Initial:
*Last Name:
 Credentials:
*Title:
*Department:
*Organization:

Business Contact Information

Please ensure you provide complete business contact information.

*Address:
*City:
*State:
 
*Zip:
*County:
*Country:
*Phone:
 Extension:
 Fax:
*Email:

Home Contact Information

Please ensure you provide complete home contact information.

*Address:
*City:
*State:
 
*Zip:
*County:
*Country:
*Mobile Phone:
  Opt in for text messages for upcoming events and reminders
*Home Phone:
 Fax:
*Email:

Define your contact preferences

ACMA allows members to customize where they receive mail and email correspondence from ACMA. Please confirm or define your preferences below.

 ACM RELATED CORRESPONDENCE BUSINESS
ADDRESS
HOME
ADDRESS
 Send my ACM email correspondence to:
 Send my ACM postal mail correspondence to:

ELIGIBILITY INFORMATION

The examination is available to registered nurses and social workers. However, there are specific eligibility requirements necessary to take the examination. These requirements include a blend of education, paid work experience* and professional practice:

     I am a Registered Nurse (RN), and I possess a valid and current nursing license that is in good standing. I have at least one (1) year**, or 2,080 hours, of full-time, supervised, paid work experience employed as a case manager or in a role that falls within the Scope of Services and Standards of Practice of a case manager, by a Health Care Delivery System.
License #:    State:    Exp Date: 
     I am a Social Worker (SW) and I have a Bachelor’s or Master’s degree from an accredited school of Social Work, OR I have a valid social work license that is in good standing. I have at least one (1) year**, 2,080 hours, of full-time, supervised, paid work experience employed as a case manger, or in a role that falls withing the Scope of Services and Standard of Practice of a case manager, by a Health Care Delivery System.
School:
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 Degree:    Year Completed:
License #:    State    Exp Date 
(if applicable)
*Please indicate your Case Management Experience (required):
Years: 
v
  Months: 
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* Paid or unpaid internship experience does not count toward work experience.

** Candidates with less than 2 years of experience must provide supervisor contact information and an attestation that they have at least one (1) year of supervised case management experience on the ACM™ application. The National Board for Case Management (NBCM) recognizes that because of case management experience, supervision and education, some case managers may be qualified to sit for the exam after only one year of experience.

*** If an applicant meets the eligibility requirements of both an RN and SW, they must indicate which exam they wish to take and provide the applicable documentation of eligibility.

Payment Information

Current Total Transaction:
Examination Fee:  $325.00

If you have been assigned a promo code, please enter it here.
Promo Code:
 
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Note: You must click "apply" for the promo code to take effect.

 Payment Method:

Applicant Declaration

I hereby declare that all information contained in this application and all documentation submitted with or in support of the application is true. I understand and agree that any misrepresentation of said facts will result in automatic disqualification to sit for the examination or revocation of the certification obtained. I acknowledge that I have reviewed and understand the information contained in the most current Candidate Handbook available online at www.acmaweb.org/acm and that I am familiar with the principles of the Accredited Case Manager (ACM™) Code of Conduct. I acknowledge that my name, city and state of residence and certification status are not considered confidential and may be published by ACMA. All other personal information will remain confidential.

*Applicant Name:

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