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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.

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

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.

Please note: if you choose to provide the Statutory Declaration Form it must include:

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.

IMPORTANT ~ PLEASE READ:

(i) All information must be typed into each CCM form (not handwritten).

(II) Each CCM form must be printed off and signed by the individual completing the form.

(ii) Each CCM form must be certified by the applicant’s supervisor/manager. Applicants without any direct line supervision should

nominate a proxy [an individual with seniority, integrity and of good standing and reputation in UAE] and contact the CMSA for

their feedback and approval.

(iv) Each CCM form must be scanned into a PDF file.

Obtaining a “certified copy” requires you to (i) make a photocopy of the original form or document - this is the copy that is to

be certified as “a copy of the original document” by your supervisor/manager or proxy (ii) Provide your supervisor/manager or

proxy with the original form or document and a photocopy of the original form or document (iii) ask your supervisor/manager or

proxy to certify the photocopy “as a copy of the original document” by adding their full name, position/title, company name (as

applicable), date and signature to the photocopied document.