© UAE Certification Guidelines 2017

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Attachment 7 - Application Checklist for Pathways 1-4

APPLICATION CHECKLIST FOR PATHWAYS 1 TO 4

PATHWAY ONE (1) – CERTIFIED PRACTISING CASE MANAGER™ Please use the list below to check that you have all the required documentation (& in the correct format) to attach to your online Certified Case Manager (CCM) application via Pathway One (1). Document Name File Type Certified copy required? Academic qualification (photocopy) PDF (scanned copy) Yes Curriculum Vitae (CV) Microsoft Word or PDF No Employment Verification Form (or UAE Statutory Declaration if self employed) PDF (scanned copy) Yes Referee Form 1 PDF (scanned copy) Yes Referee Form 2 PDF (scanned copy) Yes PATHWAY TWO (2) – CERTIFIED PRACTISING CASE MANAGER™ Please use the list below to check that you have all the required documentation (& in the correct format) to attach to your online Certified Case Manager (CCM) application via Pathway Two (2). Document Name File Type Certified copy required? Academic qualification (photocopy) PDF (scanned copy) Yes Curriculum Vitae (CV) Microsoft Word or PDF No Employment Verification Form (or UAE Statutory Declaration if self employed) PDF (scanned copy) Yes Referee Form 1 PDF (scanned copy) Yes Referee Form 2 PDF (scanned copy) Yes Certificate of Attainment: CMCT01 Case Management (National Certification) Competency Training PDF No PATHWAY THREE (3) – CERTIFIED PRACTISING CASE MANAGER™ Please use the list below to check that you have all the required documentation (& in the correct format) to attach to your online Certified Case Manager (CCM) application via Pathway Three (3). Document Name File Type Certified copy required? Academic qualification (photocopy) *as applicable* PDF (scanned copy) Yes Curriculum Vitae (CV) Microsoft Word or PDF No Employment Verification Form (or UAE Statutory Declaration if self employed) PDF (scanned copy) Yes Referee Form 1 PDF (scanned copy) Yes Referee Form 2 PDF (scanned copy) Yes Certificate of Attainment: CMCT01 Case Management (National Certification) Competency Training PDF No Professional Training and Development (PTD) Form A PDF (scanned copy) Yes Professional Training and Development (PTD) Form B PDF (scanned copy) Yes PATHWAY FOUR (4) – CERTIFIED CASE MANAGER (NON PRACTISING)™ Please use the list below to check that you have all the required documentation (& in the correct format) to attach to your online Certified Case Manager (CCM) application via Pathway Four (4). Document Name File Type Certified copy required? Curriculum Vitae (CV) Microsoft Word or PDF No Employment Verification Form (or UAE Statutory Declaration if self employed) PDF (scanned copy) Yes Referee Form 1 PDF (scanned copy) Yes Referee Form 2 PDF (scanned copy) Yes Certificate of Attainment: CMCT01 Case Management (National Certification) Competency Training PDF No Professional Training and Development (PTD) Form A PDF (scanned copy) Yes Professional Training and Development (PTD) Form B PDF (scanned copy) Yes

STEPS TO OBTAINING A CERTIFIED COPY 1.Make a photocopy of the original CCM form or document.Note: this is the copy that is to be certified as“a copy of the original document”by a supervisor/ manager or proxy. 2.Provide the supervisor/manager or proxy with the original CCM form or document along with a photocopy of the original CCM form or document. 3.Ask the supervisor/manager or proxy to certify the photocopy“as a copy of the original document”.

COMPLETINGTHE CERTIFIED CASE MANAGER (CCM) FORMS 1.All information must be typed into each CCM form (not handwritten). 2.Each CCM form must be printed off and signed by the individual completing the form. 3.Each CCM form must be certified by a supervisor/manager or proxy.For further information about ‘Certified Copies of Original Documents’ please refer to the CertificationApplication Guidelines. 4.Each CCM form must be scanned into a PDF file.

VISIT THE WEBPAGE ~ APPLICATION CHECKLIST FOR PATHWAYS 1 – 4 Website : www.cmsa.org.au Navigation menu : Certification Drop down menu: Application Checklist for Pathways 1 – 4 Note : All CCM / Statutory Declaration forms are available for download from this web page

COPYRIGHT © 2017 Case Management Society of Australia and New Zealand and Affiliates (CMSA)

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

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

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.

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