This is the Initial Application form for the Case Management (CM) examination. Please download the CM handbook for detailed information.
Completion of this form requires supporting documents. You may upload these documents directly with your application and payment or may scan/email to email@example.com or fax to 630-789-8901.
The supporting information required is:
(A) Copy of current non-restrictive RN license with expiration date
(B) 10 Contact Hours in list format AND proof of CE completion (copies of certificates for Case Management contact hours received within the previous 5 years.)
When you reach the CE portion on the application, you have the option to choose either upload a spreadsheet, or manually enter your CEs. If you are NOT uploading a spreadsheet for your continuing education, each contact hour must be individually entered in this application.
The Spreadsheet must include
a. Date of Class/Course
b. Name/Title of Class/Course
c. Sponsoring Agency
d. Number of Contact Hours
i. Your spreadsheet AND the copies of your certificates must be uploaded together.
If you have any questions, please feel free to call the office at 630-789-5799.