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UNITED ARAB EMIRATES CERTIFICATION APPLICATION GUIDELINES

C A S E M A N A G E M E N T S O C I E T Y O F A U S T R A L I A & N E W Z E A L A N D & A F F I L I A T E S 1 9 9 6

ethical | enabling | challenging | sustainable

CONTENTS

Purpose Statement for National Certification ....................................................................................... 1

The Certification Application Guidelines .............................................................................................. 1

Applying to be Certified ......................................................................................................................... 1

Stages of the Certification Process . ....................................................................................................... 2 Stage One (1) ................................................................................................................................. 4 Stage Two (2) ................................................................................................................................. 4 Stage Three (3)................................................................................................................................. 4 Stage Four (4) .................................................................................................................................. 4 The Online Application Form ................................................................................................................... 4 Pathway One (1) - Certified Practising Case Manager™ Application ............................................... 4 Pathway Two (2) - Certified Practising Case Manager™ Application ................................................ 6 Pathway Three (3) - Certified Practising Case Manager™ Application ............................................. 8 Pathway Four (4) - Certified Case Manager (Non Practising)™ Application .................................... 10 Documentation to Support an Online Application for National Certification .................................. 12 Pathway One (1) - Certified Practising Case Manager™ Application ............................................. 12 Pathway Two (2) - Certified Practising Case Manager™ Application .............................................. 13 Pathway Three (3) - Certified Practising Case Manager™ Application ........................................... 14 Pathway Four (4) - Certified Case Manager (Non Practising)™ Application .................................... 15 Certified Copies of Original Documents .............................................................................................. 16 Part A .......................................................................................................................................... 16 Part B .......................................................................................................................................... 16 Getting Documents Certified......................................................................................................... 17

Steps to Obtain a Certified Copy of an Original Document ............................................................... 18

Statutory Declarations .......................................................................................................................... 18

Auditing of Applications ........................................................................................................................ 18

Vocational Case Management Experience . .......................................................................................... 19 Employment Verification Form....................................................................................................... 19

Professional Training and Development (PTD) Activities .................................................................... 19 Professional training and Development (PTD) Form A ................................................................... 19 Professional training and Development (PTD) Form B ................................................................... 21 Examples of PTD Activities............................................................................................................. 22 Professional References ......................................................................................................................... 22 Referee Form 1 and Referee Form 2............................................................................................... 22 Online Examination ................................................................................................................................ 23 Introduction.................................................................................................................................. 23 Key Points..................................................................................................................................... 23 The Seven (7) Examination Modules . ............................................................................................ 24

Compliance with the National Standards and National Code of Ethics for Case Management ...... 25

Fees .......................................................................................................................................................... 25 Payment of Fees............................................................................................................................ 25 Schedule of Fees. .......................................................................................................................... 25

Appeals Regarding an Application for Certification ............................................................................ 25 CMSA Appeals Policy. ................................................................................................................... 25

Certified Case Manager™ Re-Endorsement......................................................................................... 26 Introduction.......................................................................................................................................... 26 Pre-requisites for CCM™ Re-endorsement............................................................................................. 26 Applying for CCM™ Re-endorsement................................................................................................... 26 The CCM™ Re-endorsement Process..................................................................................................... 26 The CCM™ Re-endorsement Forms. ..................................................................................................... 27 The CCM™ Re-endorsement Checklist ................................................................................................. 27 The CCM™ Re-endorsement Fees......................................................................................................... 28 Attachments . ......................................................................................................................................... 30 Employment Verification Form – Example Only ............................................................................. 30 Professional Training and Development (PTD) Form A – Example Only ........................................... 32 Professional Training and Development (PTD) Form B – Example Only ........................................... 34 Referee Form 1- Example Only ...................................................................................................... 36 Referee Form 2 – Example Only .................................................................................................... 38 Vocational Pathways to Certification 1 – 4 .................................................................................... 40 Application Checklist for Pathways 1 – 4 ...................................................................................... 41 UAE Statutory Declaration Form – Example Only............................................................................. 42 Re-endorsed Certified Case Manager™ - Employment Verification Form........................................ 43 Re-endorsed Certified Case Manager™ - Professional Training and Development (PTD) Form......... 45 Privacy of Your Information .................................................................................................................. 29

PURPOSE STATEMENT FOR NATIONAL CERTIFICATION The CMSA is committed to advancing the profession and practice of case management and recognises that the National Certification of Case Managers is the next step in professional recognition and development for the many individuals who are employed in case management roles (practical or theoretical) within academia, health, insurance, education, research, welfare, social and human services settings and in independent practice within United Arab Emirates. Certification encourages accountability and ensures consumer protection is a case manager’s highest concern. It underscores a case manager’s ability to work effectively in today’s multi-disciplinary team environment and is important for reassuring consumers, employers and funding bodies that the case manager has met a nationally recognised standard of practice and has the necessary skills and qualifications to perform this specialist role. It is the reverential belief of the CMSA that through the attainment of a nationally recognised minimum practice standard by all case managers, and a mandated compliance with the National Standards and National Code of Ethics, this will provide a preface for fundamental changes within the profession, thus increasing the quality of the case management services and outcomes for a client and/or their representative, throughout United Arab Emirates. THE CERTIFICATION APPLICATION GUIDELINES The Certification Application Guidelines (herein referred to as “the Guidelines”) are designed to provide you with details pertaining to the application process and transparency of the information you are required to submit to the CMSA in your application for recognition as a Certified Case Manager™. These Guidelines should be read in conjunction with the web pages of information available at www.cmsa.org.au via the Navigation Menu: Certification. It is an obligatory requirement for each applicant to read in full all of the information within the Guidelines prior to submitting their online application to the CMSA. The rationale behind this stipulation is that the applicant is fully prepared and has all the information to hand for the successful completion of their online application. For all questions and or queries related to an application the applicant should on the first occasion refer to the Guidelines and www.cmsa.org.au, for detailed information prior to contacting the CMSA. APPLYING TO BE CERTIFIED To be eligible to apply for certification an applicant must first demonstrate they have the necessary knowledge, skills, experience, and/or qualifications as described within one (1) of the four (4) Pathways to Certification (Practising or Non Practising). A copy of the Pathways to Certification has been included as an attachment to the Guidelines for your reference. All applications for recognition as a Certified Case Manager (Non Practising)™ or Certified Practising Case Manager™ must be submitted to the CMSA online. The CMSA will not accept nor process any applications (either full or part thereof) received by mail, email or facsimile. Accordingly, you will be required to provide certified copies (as outlined within the Guidelines and pursuant to your nominated pathway to certification) of all original documents (e.g. qualification or CMSA document/form) as evidence in support of your application. For these documents to be submitted to the CMSA at the time of your online application it is important that you have access to a scanned copy of each and every certified document to attach (i.e. upload from your personal computer). If you are not “computer savvy” the CMSA recommends that you seek assistance from another individual or your employer to support you in completing your online application. The CMSA regrets to inform you that we cannot provide you with this support at the time of your online application.

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The Case Management Society of Australia and New Zealand and Affiliates (CMSA) Certification sets the benchmark of excellence in case management. Certified Practising Case Managers™ (CPCM) and Certified Case Managers (Non Practising)™ (CCMNP) adhere to the CMSA National Standards and National Code of Ethics for Case Management and are recognised for their advanced education, experience, knowledge and skills by their colleagues, consumers and employers. The Case Management Society of Australia and New Zealand and Affiliates (CMSA) Certification sets the benchmark of excellence in case management. Certified Practising Case Managers™ (CPCM) and Certified Case Managers (Non Practising)™ (CCMNP) adhere to the CMSA National Standards and National Code of Ethics for Case Management and are recognised for their advanced education, experience, knowledge and skills by their colleagues, consumers and employers.

STAGES OF THE CERTIFICATION APPLICATION PROCESS There are four (4) Stages to obtaining National Certification as follows:

STAGE ONE (1) Application is submitted online to the CMSA.

Fees paid in full upon application. [Fees include an Application Fee and Year 1 Registration Fees]

A redeemable voucher code must be used by an applicant when the application fee has been pre-paid by their employer for any discounts to be applied to the fees. Other: The CMSA recommends an applicant visits the Contact Us / CMSA Business Hours (www.cmsa.org.au) for any office closures that may delay the processing of an application. If an application is urgent please contact the CMSA to discuss fast tracking the review and processing of an application prior to or following any office closures. Please refer to Stage Two for further details. STAGE TWO (PROCESSING TIME 3 - 6 WEEKS) Application is received by the CMSA and the applicant receives an automated system generated email (including a copy of the tax invoice) upon submitting the online CCM Application (i.e. order). If an applicant does not receive the aforesaid email to their inbox please contact the CMSA to confirm the application has been received. The non-receipt of a system generated email from the CMSA may indicate that a CCM Application/Order was not correctly completed and/or submitted by the applicant and therefore not received by the CMSA. Application is appraised and authenticated by the CMSA. Depending on the number of applications in progress and/or office closures this process may take up to six (6) weeks. In the event an application is urgent please contact the CMSA to discuss fast tracking the review and processing of an application. As a rule CMSA will endeavour to process a CCM Application within three (3) business days. If an application is deemed incomplete or insufficient information has been provided the applicant is contacted by the CMSA by email and advised of the deficits and asked to furnish the CMSA with the required documents and/or information necessary to process an application.

STAGE THREE Applicant is invited by the CMSA (by email) to undertake the online multiple choice examination.

Applicant is successful in completing the online examination [i.e. achieves 100% score for each of the seven (7) examination modules]

Applicant continues to re-sit the online examination until a 100% pass is achieved for each of the seven (7) examination modules.

Applicant completes the following online forms:

1. Certified Case Manager™ (CCM) Register (optional details) online form for publication on the CMSA website.

2. Delivery Request Form for delivery of their testamur and/or lapel pin.

Please note: access to both of the online forms is available from the CCM Online Examination Platform Other:

The email of invitation sent to the applicant by the CMSA includes the login details and instructions to access the CCM Online Examination Platform. Deadlines for the completion of the online examination may apply to individuals whose application is funded (i.e. paid for) by their employer. Individuals with funded applications will need to check with their employer as to any external time restrictions placed on the completion of the online examination; pursuant to the Terms & Conditions of your employer funded application.

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STAGE FOUR (PROCESSING TIME 2 - 3 WEEKS) Stage Four commences upon the applicant receiving 100% accuracy for each of the seven (7) examination modules. These results are automatically emailed to the CMSA for processing. Please note: The successful applicant will not be contacted by the CMSA until their examination results have been processed and formal endorsement has been granted by the CMSA Board of Management. The final endorsement process may take from 1 to 3 weeks before the successful applicant receives a congratulatory email from the CMSA. Following this email a CPCM or CCMNP Testamur and lapel pin [available to CPCM’s only] is dispatched to the CCM from the CMSA Applicant’s examination results are reviewed and processed by the CMSA and final paperwork is completed for signatory approval and endorsement by two (2) representatives of the CMSA Board of Management. Successful applicant is sent a congratulatory email from the CMSA confirming their three (3) year endorsement as a Certified Case Manager™ and their details are added to the CCM Online Register. Whilst the final stage of the application process may take 1-3 weeks, the CCM endorsement is back-dated by the CMSA to the date the applicant received 100% for each of the seven (7) examination modules. This date becomes the applicant’s registration/renewal date as a Certified Case Manager™. Important: A Certified Case Manager™ endorsement is valid for a three (3) year term at which time the Certified Case Manager™ is required to submit an online application for Re-endorsement as a Certified Case Manager™ in order to maintain compliance with National Certification requirements. To maintain the continuity of their certification status, a Certified Case Manager™ is required to complete the CCM Re-endorsement application prior to the expiration date of their current Certified Case Manager™ endorsement (i.e. registration date). A Certified Case Manager™ Annual Registration Fees for Year 2 & Year 3 must be honoured to maintain certification status.

When applying for a three (3) year re-endorsement, an existing Certified Case Manager™ must provide evidence of:

1. one (1) year FTE (1824 hrs) vocational case management practice experience in the past three (3) years.

2. twenty four (24) hours of Professional Training and Development (PTD) in the past three (3) years.

To learn more about CCM Re-endorsement please go to www.cmsa.org.au and visit the Navigation Menu: Certification

DELAYS IN PROCESSING APPLICATIONS

The timeframes within the application process (as outlined above) should be used by the applicant as a guide only. Whilst the CMSA will endeavour at all times to process your application pursuant to these guidelines there may be circumstances (foreseeable or non foreseeable) which arise resulting in a delay to your application.

These may include:

• Incomplete or insufficient application submitted by applicant. • Applicant fails to achieve a successful pass in the online examination and must re-sit online examination. • Variations to the business hours and operations of the CMSA, including Public Holidays, temporary closure of the CMSA office or limitations on CMSA resources i.e. staff leave or absences or high volume of applications. • Technical issues affecting access to the CMSA website, internet, client management systems or software.

• Delays in delivery or receipt of products from suppliers to the CMSA. • Delays in receipt of products to the applicant from Australia Post.

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THE ONLINE APPLICATION FORM Each applicant will be required to submit different information, and certified scanned copies of evidence, at the time of the online application. It is important that you read and prepare the information and/or evidence (attachments) pursuant to your nominated Pathway to Certification (as outlined below) in readiness for your online application. Where “attachments” are requested you are required to upload a scanned copy or PDF copy of the document requested. Please ensure you have these copies available to access at the time of your online application. It is important you understand that you must provide all information as requested in order for your application to be processed by the CMSA. Omitting (by default) any required information as listed below will render your application invalid by the CMSA and you will be required to resubmit your online application.

PATHWAY 1 – CERTIFIED PRACTISING CASE MANAGER™ APPLICATION

Title

First Name

Last Name

Gender

Business Address - Street Name/PO Box

Business Address Line 2

Business Address Line 3

Area

Emirate State / Province

Postal code

Country

Business Phone

Mobile

Primary Email Address

Secondary Email Address

Date of Birth

Employer Name (Agency)

Position Title

Department Name I am applying via the following Vocational Pathway to Certification.

1. Pathway 1

I have read the Certification Application Guidelines

1. Yes 2. No - Please ensure you have read these guidelines prior to continuing with your application 1. Pathway 1 - CHC82015 OR Masters degree, PhD in Case Management

Please select and attach evidence of your minimum level of qualification. Copy must be certified.

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I have attained the minimum vocational case management experience. Please note you must have practised for 12 months (1824 hrs) in the last 3 years Please attach the Employment Verification Form (copy must be signed by your employer & Certified) OR if Self Employed please attach a Statutory Declaration. Please attach Referee Form 1 (copy must be signed and Certified) Please attach Referee Form 2 (copy must be signed and Certified) I have submitted the following evidence as a mandatory requirement of my application and acknowledge that failure to do so will render my application incomplete for the purpose of assessment by the CMSA. I solemnly and sincerely commit to read, understand, utilise and apply the CMSA National Standards and National Code of Ethics within all my professional interactions as a Certified Practising Case Manager™ and member of the CMSA. I solemnly and sincerely declare that the contents of this application, including all information provided for and on my behalf, is true and correct to the best of my knowledge and belief. I acknowledge that the CMSA will conduct random audits of applications and if audited I will be required to provide evidence of any or all claims within my application within 28 days of notice by the CMSA. I have read and acknowledge the Certification Appeals Policy. I have read and consent to the CMSA Privacy Policy (see www.cmsa.org.au) and understand how it relates to the use of my personal information. I have read, acknowledge and agree to abide by the CMSA Constitution and By-laws Disclaimer of Liability - I acknowledge full responsibility for any (if required) Professional Indemnity Insurance and recognise the CMSA is not liable for any professional malpractice, misconduct, injury, damages, fraudulent or criminal acts pursuant to my registration as a Certified Practising Case Manager™ Please attach a copy of your Curriculum Vitae (CV)

1. Pathway 1- 2 years FTE (3648 hrs)

1. Employment Verification Form 2. Self Employed (Statutory Declaration)

1. Qualifications 2. Employment Verification Form OR Statutory Declaration 3. Curriculum Vitae (CV)

4. Referee 1 5. Referee 2

I hereby agree

I hereby declare and acknowledge

1. Yes 2. No

I hereby agree

I hereby acknowledge

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PATHWAY 2 – CERTIFIED PRACTISING CASE MANAGER™ APPLICATION

Title

First Name

Last Name

Gender

Business Address - Street Name/PO Box

Business Address Line 2

Business Address Line 3

Area

Emirate State / Province

Postal code

Country

Business Phone

Mobile

Primary Email Address

Secondary Email Address

Date of Birth

Employer Name (Agency)

Position Title

Department Name I am applying via the following Vocational Pathway to Certification.

2. Pathway 2

I have read the Certification Application Guidelines.

1. Yes 2. No - Please ensure you have read these guidelines prior to continuing with your application

Please select and attach evidence of your minimum level of qualification. Copy must be certified. I have attained the minimum vocational case management experience. Please note you must have practised for 12 months (1824 hrs) in the last 3 years? Please attach the Employment Verification Form (copy must be signed by your employer & Certified) OR if Self Employed please attach a Statutory Declaration.

2. Pathway 2 - Undergraduate Bachelor degree (from any discipline)

2. Pathway 2 - 3 years FTE (5472 hrs)

1. Employment Verification Form 2. Self Employed (Statutory Declaration)

Please attach a copy of your Curriculum Vitae (CV)

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Please select and attach your Certificate of Attainment CMCT01 Please attach Referee Form 1 (copy must be signed and Certified)

2. Pathway 2

Please attach Referee Form 2 (copy must be signed and Certified)

I have submitted the following evidence as a mandatory requirement of my application and acknowledge that failure to do so will render my application incomplete for the purpose of assessment by the CMSA.

1. Qualifications 2. Employment Verification Form OR Statutory Declaration 3. Curriculum Vitae (CV) 4. Certificate of Attainment CMCT01

5. Referee 1 6. Referee 2

I solemnly and sincerely commit to read, understand, utilise and apply the CMSA National Standards and National Code of Ethics within all my professional interactions as a Certified Practising Case Manager™ and member of the CMSA. I solemnly and sincerely declare that the contents of this application, including all information provided for and on my behalf, is true and correct to the best of my knowledge and belief. I acknowledge that the CMSA will conduct random audits of applications and if audited I will be required to provide evidence of any or all claims within my application within 28 days of notice by the CMSA. I have read and consent to the CMSA Privacy Policy (see www.cmsa.org.au) and understand how it relates to the use of my personal information. I have read, acknowledge and agree to abide by the CMSA Constitution and By-laws Disclaimer of Liability - I acknowledge full responsibility for any (if required) Professional Indemnity Insurance and recognise the CMSA is not liable for any professional malpractice, misconduct, injury, damages, fraudulent or criminal acts pursuant to my registration as a Certified Practising Case Manager™ I have read and acknowledge the Certification Appeals Policy.

I hereby agree

I hereby declare and acknowledge

1. Yes 2. No

I hereby agree

I hereby acknowledge

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PATHWAY 3 – CERTIFIED PRACTISING CASE MANAGER™ APPLICATION

Title First Name Last Name Gender

Business Address - Street Name/PO Box

Business Address Line 2

Business Address Line 3

Area

Emirate State / Province

Postal code

Country Business Phone Mobile Primary Email Address Secondary Email Address Date of Birth Employer Name (Agency) Position Title Department Name I am applying via the following Vocational Pathway to Certification. Please select and attach evidence of your minimum level of qualification. Copy must be certified. I have attained the minimum vocational case management experience. Please note you must have practised for 12 months (1824 hrs) in the last 3 years? Please attach the Employment Verification Form (copy must be signed by your employer & Certified) OR if Self Employed please attach a Statutory Declaration. Please attach a copy of your Curriculum Vitae (CV) Please attach a scanned copy of all PTD Form A as a record of your PTD activities (each copy must be signed and Certified). Note: You must scan all copies of Form A into one (1) PDF document only. Multiple uploads are not available. I have read the Certification Application Guidelines.

3. Pathway 3

1. Yes 2. No - Please ensure you have read these guidelines prior to continuing with your application 3. Pathway 3 - Diploma OR Certificate OR no formal qualification

3. Pathway 3. 5 years FTE (9120 hrs)

1. Employment Verification Form 2. Self Employed (Statutory Declaration)

Upload PTD Form/s A (One PDF file only of all scanned copies of Form A)

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Please attach a scanned copy of the PTD Form B as a summary of all 72 hrs of PTD activities (copy must be signed and Certified). Please select and attach your Certificate of Attainment CMCT01 Please attach Referee Form 1 (copy must be signed and Certified) I have submitted the following evidence as a mandatory requirement of my application and acknowledge that failure to do so will render my application incomplete for the purpose of assessment by the CMSA. I solemnly and sincerely commit to read, understand, utilise and apply the CMSA National Standards and National Code of Ethics within all my professional interactions as a Certified Practising Case Manager™ and member of the CMSA. I solemnly and sincerely declare that the contents of this application, including all information provided for and on my behalf, is true and correct to the best of my knowledge and belief. I acknowledge that the CMSA will conduct random audits of applications and if audited I will be required to provide evidence of any or all claims within my application within 28 days of notice by the CMSA. I have read and acknowledge the Certification Appeals Policy. I have read and consent to the CMSA Privacy Policy (see www.cmsa.org.au) and understand how it relates to the use of my personal information. I have read, acknowledge and agree to abide by the CMSA Constitution and By-laws Disclaimer of Liability - I acknowledge full responsibility for any (if required) Professional Indemnity Insurance and recognise the CMSA is not liable for any professional malpractice, misconduct, injury, damages, fraudulent or criminal acts pursuant to my registration as a Certified Practising Case Manager™

Upload PTD Form B

3. Pathway 3

Please attach Referee Form 2 (copy must be signed and Certified) 1. Qualifications (as applicable) 2. Employment Verification Form OR Statutory Declaration 3. Curriculum Vitae (CV) 4. Professional Training and Development (PTD) Form 5. Certificate of Attainment CMCT01

6. Referee 1 7. Referee 2

I hereby agree

I hereby declare and acknowledge

1. Yes 2. No

I hereby agree

I hereby acknowledge

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PATHWAY 4 – CERTIFIED CASE MANAGER (NON PRACTISING)™ APPLICATION

Title First Name Last Name Gender

Business Address - Street Name/PO Box

Business Address Line 2

Business Address Line 3

Area

Emirate State / Province

Postal code

Country

Business Phone

Mobile

Primary Email Address

Secondary Email Address

Date of Birth

Employer Name (Agency)

Position Title

Department Name I have read the Certification Application Guidelines.

1. Yes 2. No - please ensure you have read these guidelines prior to continuing with your application 1. Yes 2. No - you have failed to meet the pre-requisite requirement for this application 1. Delivery of Case Management 2. Supervision of Case Managers 3. Management of Case Management Programs and/or Portfolios

I have a minimum of 2 years FTE (3618 hrs) vocational case management experience. Please note you must have practised for 12 months (1824 hrs) in the last 3 years? Please select area of case management practice (i.e. practical or theoretical)

4. Case Management Education 5. Case Management Research

Please attach the Employment Verification Form (copy must be signed by your employer & Certified) OR if Self Employed please attach a Statutory Declaration. Please attach a copy of your Curriculum Vitae (CV) Please attach your Professional Training and Development Forms A and Form B (copies must be signed and Certified)

1. Employment Verification Form 2. Self Employed (Statutory Declaration)

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Please attach a scanned copy of all PTD Form A as a record of your PTD activities (each copy must be signed and Certified). Note: You must scan all copies of Form A into one (1) PDF document only. Multiple uploads are not available. Please attach a scanned copy of the PTD Form B as a summary of all 72 hrs of PTD activities (copy must be signed and Certified). Please attach Referee Form 1 (copy must be signed and Certified) Please attach Referee Form 2 (copy must be signed and Certified) I solemnly and sincerely commit to read, understand, utilise and apply the CMSA National Standards and National Code of Ethics within all my professional interactions as a Certified Case Manager (Non Practising)™ and member of the CMSA. I solemnly and sincerely declare that the contents of this application, including all information provided for and on my behalf, is true and correct to the best of my knowledge and belief. I acknowledge that the CMSA will conduct random audits of applications and if audited I will be required to provide evidence of any or all claims within my application within 28 days of notice by the CMSA. I have read and acknowledge the Certification Appeals Policy. I have read and consent to the CMSA Privacy Policy (see www.cmsa.org.au) and understand how it relates to the use of my personal information. I have read, acknowledge and agree to abide by the CMSA Constitution and By-laws Disclaimer of Liability - I acknowledge full responsibility for any (if required) Professional Indemnity Insurance and recognise the CMSA is not liable for any professional malpractice, misconduct, injury, damages, fraudulent or criminal acts pursuant to my registration as a Certified Case Manager (Non Practising)™

Upload PTD Form/s A (One PDF file only of all scanned copies of Form A)

Upload PTD Form B

1. Employment Verification Form OR Statutory Declaration 2. Curriculum Vitae (CV) 3. Professional Training and Development (PTD) Form 4. Certificate of Attainment CMCT01

5. Referee 1 6. Referee 2

I hereby agree

I hereby declare and acknowledge

1. Yes 2. No

I hereby agree

I hereby acknowledge

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DOCUMENTATION TO SUPPORT AN ONLINE APPLICATION FOR NATIONAL CERTIFICATION

PATHWAY ONE (1) ~ CERTIFIED PRACTISING CASE MANAGER™ PRE-REQUISITES FOR PATHWAY ONE (1) DOCUMENT NAME

FILE TYPE

CERTIFIED COPY REQUIRED?

CHC82015 Graduate Certificate in Client Assessment and Case Management

Academic/Professional Qualification (photocopy)

PDF (scanned copy)

Yes*

OR PhD in case management

OR Masters degree in case management (excludes Grad Diploma)

Copy of Curriculum Vitae (CV Microsoft Word or PDF

two (2) years FTE (3648 hrs) vocational case management practice experience²

Employment Verification Form or CMSA UAE Statutory Declaration ¹ ²

PDF (scanned copy)

Yes*

Two (2) professional referees³ Referee Form 1³ Referee Form 2³

PDF (scanned copy)

Yes*

EXPLANATORY NOTES

These documents are submitted as evidence (proof) of your stated level of skills, knowledge, experience and/or qualifications and to substantiate your eligibility to apply for endorsement as a Certified Practising Case Manager™ via Pathway One (1).These documents are essential for the CMSA to authenticate your application and are uploaded to the online CPCM application form. As you complete the online form you will be prompted to do so. ¹ The CMSA UAE Statutory Declaration Form may be used for Pathway One (1) in lieu of the Employment Verification Form should an applicant be self-employed and/or need to reference multiple employers/appointments for the required two (2) years FTE (3648 hrs) of vocational case management experience. 1. the total hours of your vocational case management experience - this must be equal to or greater than the hours as stated within this Pathway (i.e. >3648 hrs) 2. your vocational case management experience in chronological order commencing with your most recent position including: the dates you commenced and ceased employment in each position (in month and year format MM /YY), your position title, your employers name (company name) and location (area, emirate state/province, country). ² Vocational case management experience must be recent. An applicant must demonstrate they have practised for at least 12 months (1824 hrs) in the last 3 years. ³ Referees must have been in professional working relationship with the applicant for at least 6 months in the last 3 years and familiar with the applicant’s professional practice and their certification application. Please note: if you choose to provide the Statutory Declaration Form it must include:

C E R T I F I E D C A S E M A N A G E R S U N I T E D A R A B E M I R A T E S

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