Certified Medical Interpreter

NBCMI Candidate Handbook

January 8, 2025

National Board of Certification for Medical Interpreters

www.certifiedmedicalinterpreters.org
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Table of Contents
Introduction ...............................................................................................................................3
Statement of Purpose and Scope............................................................................................................. 3
Earning the Hub-CMI Credential ............................................................................................................. 4
Earning the CMI Credential ....................................................................................................................... 4
Applying for Our Credentialing Programs .......................................................................5
Application Requirements ........................................................................................................................ 5
Prerequisites .................................................................................................................................................. 5
Eligibility Appeals ........................................................................................................................................ 7
Preparing for the Exams .........................................................................................................8
How the Exams Were Developed ............................................................................................................ 8
Studying for the Exams ............................................................................................................................... 9
Written Exam Content Outline.............................................................................................................. 10
Oral Exam Content Outline..................................................................................................................... 12
Taking the Exams................................................................................................................... 13
Written Exam .............................................................................................................................................. 13
Oral Exam ..................................................................................................................................................... 13
What to Expect on Exam Day (Oral & Written Exams) ................................................................. 14
Cheating ........................................................................................................................................................ 16
After the Exams ...................................................................................................................... 17
Written Exam Results............................................................................................................................... 17
Oral Exam Results...................................................................................................................................... 17
Understanding Your Score Reports .................................................................................................... 17
Retesting ....................................................................................................................................................... 18
Examination Appeals ............................................................................................................................... 18
Maintaining Credentials ...................................................................................................... 19
Renewal Requirements ........................................................................................................................... 19
Fees & Deadlines ........................................................................................................................................ 20
Extensions .................................................................................................................................................... 20
Documentation Required ....................................................................................................................... 20
Acceptable Continuing Education........................................................................................................ 21
Recertification Procedures .................................................................................................................... 22
Appeals Process for Renewal CEUs ..................................................................................................... 22
Failure to Renew ........................................................................................................................................ 22
Policies ...................................................................................................................................... 23
Special Accommodations ........................................................................................................................ 23
Nondiscrimination .................................................................................................................................... 27
Confidentiality ............................................................................................................................................ 27
Use of the Credentials .............................................................................................................................. 27
Disciplinary Policy & Procedure .......................................................................................................... 28
Complaints ................................................................................................................................................... 29
Appeals .......................................................................................................................................................... 30
Appendix A: Special Accommodation Request Form ................................................. 31

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Introduction

The mission of the National Board is to foster improved healthcare outcomes, patient
safety and patient/provider communication, by elevating the standards for and quality
of medical interpreting through a nationally recognized and accepted certification for
medical interpreters.

The CMI certification program is governed by the National Board of Certification for
Medical Interpreters (National Board), an independent division of the International
Medical Interpreters Association (IMIA).

Statement of Purpose and Scope

The National Board of Certification for Medical Interpreters is a nationally recognized
certifying body in the United States that offers a Certified Medical Interpreter (CMI)
credential to medical interpreters. The CMI credential is the most prestigious credential
offered in the industry. As demand for certification grows and becomes an industry
standard, the National Board's CMI credential will open career and professional
development opportunities that no other credential can.

The purpose of the CMI certification program is to ensure that the standards met are
those necessary for safe and ethical practice of the medical interpreter profession.

The careful vetting process and high standards held by the National Board are just
some of the reasons employers and care providers prefer working with CMIs-- knowing
they will be compliant with regulatory guidelines, provide complete and accurate
interpretation, and promote patient safety.

According to the Bureau of Labor Statistics, in 2014 there were approximately 7,000
interpreters and translators employed in health care industries in the United States:
5,100 worked in hospitals and nursing care facilities, and 1,900 worked in ambulatory
healthcare services (offices of physicians and other health practitioners, home
healthcare services, and outpatient care centers). The combined fields of health care
and social assistance employ 15.7% of the interpreters and translators in the US, and
the occupation of interpreter/translator was projected to grow at a rate of 29%
between 2014 and 2024. Based on the NBCMI national Job Task Analysis conducted in
2017, medical interpreters are employed in many settings, including: health
departments, hospitals and urgent care facilities, medical and teaching/research
centers, community clinics, medical private practices, pharmacies, testing and
diagnostic centers, health fairs and related events, laboratories, video and telephonic
interpretation call centers.

Medical Interpreters work for translation/interpretation companies or individual

organizations, and many interpreters also work from home. Self-employed interpreters

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frequently have variable work schedules. Most interpreters and translators work full
time during regular hours.

The CMI certification program provides a valid and reliable credential for entry-level
medical interpreters to recognize their education, knowledge, and professional
expertise. The program also continues to uphold the same high standards by requiring
professional development (continuing education) toward re- certification after 5 years of
obtaining the CMI credential.

The CMI certification provides a national credential that crosses state lines in case of
national disasters and ensures compliance with many state requirements that demand
that services are provided by competent individuals.

The purposes of the National Board are to:

• Develop, organize, oversee and promote a national medical interpreter certification
program in all languages.
• Promote patients and providers working with credentialed medical interpreters who
have met minimal national standards to provide accurate and safe interpretation.
• Ensure credibility of national certification by meeting or exceeding nationally
accepted standards including transparency, inclusion, and access.

The Board of Directors of the National Board consists of voting members that include
medical interpreters, a health care provider, industry representatives, and a public
member. Initial Board members were selected by a public process and independent
selection committee. Subsequently, Board members are recruited through a Nominating
Committee process and are elected by the members of the National Board.

Earning the Hub-CMI Credential

The Hub-CMI is a credential available to all interpreters, regardless of target language
and is non-language specific. Candidates who have passed the written exam (the exam
is in English) are eligible for the Hub-CMI credential. If there is a CMI credential
available in your target language, your Hub-CMI will expire in two years with no option
for renewal. Hub-CMIs that expire can only restart the program once and pass the
written exam a total of two times. In order to qualify for the second Hub-CMI you must
attempt the oral exam at least once.

Earning the CMI Credential

Certification is available in six languages: Spanish, Russian, Mandarin, Cantonese,
Korean, and Vietnamese. The CMI credential is awarded in the specific languages for
which the oral exam is passed (for example: CMI-Spanish, CMI-Korean).

The National Board only awards the CMI credential to individuals who meet all of the
eligibility criteria and earn a passing score on both the written and oral examinations.

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Applying for Our Credentialing Programs

Application Requirements
To apply for our credentialing programs, submit the application online at
www.certifiedmedicalinterpreters.org.

You will upload your prerequisite documentation as part of the application form. The
non-refundable registration fee is $40, and it is valid for one (1) year.

After you submit your application, you will hear from your program advisor in about two
weeks to let you know your application status. Your application status will be kept
confidential.

Note: You must register using the name(s) printed on your picture ID (such as a driver’s
license or passport). You must present your ID in order to take the tests, and the name(s)
on your ID MUST MATCH the name(s) in our records.

To apply for the credential programs, a candidate must submit the National Board CMI
program application on the National Board website. As part of the application form, the
candidate must submit prerequisite documentation. The candidate must register using
the name(s) printed on their photo ID.

Prerequisites
All candidates for the Hub-CMI and CMI credentials must meet the following
prerequisites:

1. Minimum Age: All candidates must submit proof of being at least 18 years old
(the age of majority as defined by the federal government). A driver’s license or
a birth certificate or passport copy are acceptable proofs of age.
2. General Education: All candidates must submit proof of having at least a high
school education level. A high school diploma, a GED, or any degree from an
institution of higher education are acceptable proofs of general education.
3. Profile Photo: All candidates must upload a recent professional photo of
themselves to their NBCMI profile.
4. Medical Interpreter Education: All candidates must submit proof of training
specific to medical interpreting.
o Medical interpreter training that was taken at a college or university must
be at least 3 credit hours; a transcript is the only acceptable proof.
o Medical interpreter training courses must be at least 40 hours; a
Certificate of Completion from an approved medical interpreter training
course is the only acceptable proof. These are IMIA’s accredited trainings:

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http://www.imiaweb.org/education/accreditationhistory.asp. The National

Board cannot recommend one course over another and is not responsible
for the content of any course listed. Neither NBCMI nor IMIA is involved in
the development of these training courses. No NBCMI staff is involved in
the approval of training courses.

Disclaimer: Neither NBCMI nor IMIA is responsible or Legally liable for

any of these training courses content, development, marketing,
operations, or business practices.

5. Oral proficiency in English: All candidates must submit proof of oral

proficiency in English by submitting one of the following:
o Bachelor’s, Master’s, PhD, or any other degree from an institution of
higher education in the U.S. or other English language country.
o High school diploma from a high school in the U.S. or other English
language country or from an American School abroad.
o One of the following tests (subject to change)
▪ TOEFL (Test of English as a Foreign Language): 570+ on paper;
230+ on computer version; 90+ on iBT.
▪ ELPT (English Language Proficiency Test): 950+
▪ MELAB (Michigan English Language Assessment Battery) 80+
▪ ECPE (Examination for the Certificate of Proficiency in English):
PASS
▪ FCE (First Certificate in English, Level 3): A
▪ CAE (Certificate in Advanced English, Level 4): B
▪ CPE (Certificate of Proficiency in English, Level 5): B .
▪ IELTS (International English Language Testing System) 7.0
▪ Parrot: Level ILR 2+ (follow this link https://languagetest.com)
6. Oral proficiency in target language: All candidates must submit proof of oral
proficiency in the target language by submitting one of the following:
o Bachelor’s, Master’s, PhD, or any other degree from an institution of
higher education where the target language is spoken.
o High school diploma from a high school in a country where the target
language is spoken
o 24+ semester college credit hours for the target language
o ACTFL Oral Exams (American Council on the Teaching of Foreign
Languages): Advanced Mid Level (follow this link:
https://www.languagetesting.com/oral-proficiency-interview-by-computer-
opic) both the OPI (telephonic) and OPIc (computer recording) are
acceptable.

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o Parrot: Level ILR 2+ (follow this link https://languagetest.com)

Eligibility Appeals
If an applicant is informed during the registration process of the denial of proof of
prerequisites or ability to sit for the oral or written exams, they may appeal this
decision. The appeal should include:

▪ An appeal letter from the applicant clearly stating why they believe the decision
was wrong. Specific information based on facts to show that the exam should be
administered should be included
▪ A letter from the candidate’s supervisor addressing specifics regarding the
candidate’s experience and why they believe they should sit for the exam (if
applicable).
▪ Any other pertinent information from the candidate’s employer/professor.

The appeal should be sent to [email protected] within 30 days of

receipt of notification of the adverse decision. The National Board reviews exam appeals
by email within thirty (30) days of receipt of the appeal. Notice of the final
determination shall be provided to the appellant within ten (10) business days of the
decision. The determination of the Board of Directors of the National Board will be final.

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Preparing for the Exams

How the Exams Were Developed

The written and oral examinations were developed based on a Job Analysis Study
conducted by PSI (a nationally recognized independent testing company) with support
from numerous medical interpreters, the International Medical Interpreters Association,
and Language Line University.

The Job Analysis and subsequent development of the written and oral exams were
conducted in accordance with the Standards for Educational and Psychological Testing
(AERA, APA, NCME, 1999). The process included a national Job Analysis, creating
detailed examination specifications, development of exam items, pilot testing, and
psychometric analysis.

Job Analysis
The examinations were founded upon a national job analysis conducted in January
2009. The job analysis study used a multiple-method approach, incorporating expert
judgments of an advisory committee, focus groups with participants from across the
country, and a national survey of practicing professionals.

The advisory committee was comprised of 44 experienced medical interpreting

professionals representing every region of the United States, including active medical
interpreters, medical interpreting program managers, and medical interpreter trainers
and advocates for healthcare interpreting.

The expert committee defined professional activities and knowledge requirements to be

included in a job analysis survey and the survey was administered online to a national
sample of practicing professionals. It was completed by 1,506 respondents, who were
representative of the population of the medical interpreting profession.

Examination Specifications
A statistical analysis of the responses to the job analysis survey was conducted by PSI
to determine which of the professional activities and knowledge statements qualified for
testing on the medical interpreter certification exams. An expert panel was convened to
review and confirm the survey results. The panel developed examination content
specifications for the written and oral exams from the job analysis data through a
combination of empirical and rational methods.

Test Item Development and Review

With PSI’s guidance and training a panel of experts was convened to write, review and
formally evaluate test items for the oral exam measuring sight translation and

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consecutive interpreting skills. Additional experts participated in writing, reviewing and

formally evaluating written exam items based on the exam content specifications.

Following a rigorous training process on test item writing and standard setting, each
panel of experts began the test item writing process, based on the test specifications
established by the job analysis. Subject Matter Experts (SMEs) evaluated each item with
respect to relevance to occupational requirements and the need for competence upon
certification; and estimated difficulty for practicing professional interpreters.

Following extensive pilot testing of both the written and oral exams, final exam forms
were developed and administered. No credentials were granted for taking the pilot
exams; the data was used to finalize both exams.

Studying for the Exams

Candidates are encouraged to be familiar with the recognized Interpreter Standards of
Practice, Codes of Ethics, and the CLAS Standards:

▪ CHIA Standard of Practice (www.chiaonline.org)

▪ IMIA Standards of Practice (www.imiaweb.org/standards/)
▪ IMIA Code of Ethics (www.imiaweb.org/code/)
▪ NCIHC Ethics and Standards of Practice (www.ncihc.org/ethics-and-standards-of-
practice)
▪ CLAS Standards (https://thinkculturalhealth.hhs.gov/clas)

In addition, candidates should review the exam content outlines below.

Additional Study Tips

▪ Review medical terminology using medical glossaries and dictionaries

▪ Review basic medical information and human anatomy.
▪ Review interpreter training manuals such as CCCS and ACEBO.
▪ Attend workshops, conferences, and other training opportunities.
▪ Review regulations and guidelines, including:
o The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Privacy Rule (https://www.cdc.gov/phlp/publications/topic/hipaa.html)
o Title VI and the Civil Rights Act of 1964 (www.LEP.gov)
o HHS Office of Civil Rights (www.hhs.gov/ocr/)
▪ Review resources on cultural awareness
o The Cross Cultural Health Program (www.xculture.org)

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o HHS Office of Minority Health Cultural Competency

(minorityhealth.hhs.gov)
o EthnoMed (ethnomed.org)

The above references are just a sample of the information that is available on the
Internet; these citations do not indicate endorsement.

Written Exam Content Outline

The written exam is offered only in English. The written exam is a multiple choice,
computerized exam, containing 51 questions. The written exam evaluates:

8% Topic 1: Roles of the Medical Interpreter

> Role of Conduit
> Role of Clarifier
> Role of Culture Broker
> Role of Patient Advocate

15% Topic 2: Medical Interpreter Ethics

> Confidentiality
> Accuracy and completeness
> Impartiality
> Conflict of Interest
> Scope of Practice
> Disqualification/Impediments to Performance
> Professional Courtesy
> Professional Development

8% Topic 3: Cultural Competence

> Cultural practices related to healthcare
> Familial and relational structures

38% Topic 4: Medical Terminology in Working Languages

> Medical Tests and Diagnostic Procedures
> Medical Apparatus
> Pharmacology
> Pathologies
> Symptomatology
> Anatomy
> Musculoskeletal System
> Endocrine System
> Cardiovascular System
> Respiratory System
> Urinary System
> Nervous System
> Digestive System

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> Reproductive Systems

> Integumentary System
> Treatments
> Acronyms and Abbreviations (e.g., MRI, CAT scan, etc.)

23% Topic 5: Medical Specialties in Working Languages

> Obstetrics and Gynecology/Genetic Counseling
> Organ Transplant
> Pharmacy
> Ear, Nose and Throat (ENT)
> Pediatrics
> Emergency Medicine
> Oncology
> Surgery
> Orthopedics
> Radiology
> Nutrition Counseling
> Physical, Speech and Occupational Therapy
> Urology and Nephrology
> Endocrinology
> Ophthalmology
> Cardiology
> Neurology
> Hematology
> Dermatology
> Psychiatry
> Respiratory Illness

5% Topic 6: Interpreter Standards of Practice

> IMIA (International Medical Interpreters Association) Standards
> NCIHC (National Council on Interpreting in Healthcare) Standards
> CHIA (California Healthcare Interpreters Association) Standards

3% Topic 7: Legislation and Regulations

> Health Insurance Portability and Accountability Act (HIPAA)
> CLAS (Culturally and Linguistically Appropriate Services) Standards

Note: In addition to the number of examination items specified, a small number (five to
ten) “pretest” questions may be administered to candidates during the examinations.
These questions will not be scored and the time taken to answer them will not count
against examination time. The administration of such non-scored experimental questions
is an essential step in developing future examinations.

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Oral Exam Content Outline

The oral exam is a computerized exam that is 45-60 minutes in length. Candidates have
10 minutes to complete 2 sight translation passages and 30 minutes to complete 12
mini-scenarios. The oral exam evaluates:

15% Topic 1: Mastery of Linguistic Knowledge of English

15% Topic 2: Mastery of Linguistic Knowledge of the other language

25% Topic 3: Interpreting Knowledge and Skills

10% Topic 4: Cultural Competence

25% Topic 5: Medical Terminology in Working Languages

10% Topic 6: Medical Specialties in Working Languages

To assist you with the oral exam format, a Candidate Preparation Document with
detailed information on the exam format is available on the NBCMI website.

Simultaneous interpreting, written translation, and sight translation into English are not
tested. The job analysis showed that while medical interpreters sometimes perform
these tasks, the frequency was not statistically significant.

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Taking the Exams

The oral and written exams are offered via computer based testing (CBT) at
professional testing centers through contracted test administration vendors. The written
exam must be taken and passed before the oral exam may be scheduled.

Written Exam
Candidates are eligible to take the written exam after their application, with
documentation of prerequisites, has been approved by the National Board. The written
exam is offered only in English, and any candidate who meets the prerequisites may
take the exam, regardless of language.

After receiving approval to take the written exam from the National Board, candidates
will receive detailed instructions on how to schedule their exam. The cost is $190. and
exams are given year-round. The exam must be scheduled within 6 months from the
date of approval.

The written exam is a multiple choice, computerized exam, containing 51 questions. All
candidates will have up to 75 minutes to complete the exam.

Oral Exam
Once a candidate successfully passes the written exam the Hub-CMI credential will be
granted. If there is no oral exam available in the Hub-CMI’s target language, he/she will
not be eligible to take the oral exam. If there is a CMI certification available (Spanish,
Cantonese, Mandarin, Russian, Korean, and Vietnamese), the candidate has up to 2
years to pass the oral exam for the CMI credential. The Hub-CMI will expire in 2 years
with no option for renewal.

If there is a CMI certification available the candidate will receive information on how to
schedule their oral exam. The cost is $300 and the exam is given year-round.
Candidates are recommended to take the oral exam within 6 months of the date they
pass the written exam. Once the oral exam has been scheduled, candidates are sent
additional information with confirmation of their testing appointment and test center
policies.

Note: If the oral exam is not available for the candidate’s language, and the oral exam
for their language is developed later, they will have six months from the time the oral
exam in their language is launched in order to take the exam.

Candidates are allowed 45-60 minutes to complete the oral exam; 30 minutes for 12
mini-scenarios and 10 minutes for 2 sight translation passages. The exam is computer-
based and candidate’s oral responses will be recorded.

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Detailed information on taking the oral exam is available online at

www.certifiedmedicalinterpreters.org.

Candidates should review carefully the Candidate Preparation Document, which

contains the Examination Security policy. This document is available on the National
Board website. Failure to follow candidate instructions will result in the application being
voided and forfeiture of the fee for the exam.

All tests are recorded and kept on file in a secure location for quality assurance
purposes, as well as to ensure the reliability and validity of the assessment.

What to Expect on Exam Day (Oral & Written Exams)

The written and oral exams are offered via computer based testing (CBT) and are
supervised by designated proctors at professional testing centers. To provide a fair and
consistent environment for all candidates, the exams are delivered using standardized
procedures and following strict security protocols.

Candidates are required to follow all exam rules at all times. Failure to follow these
rules may result in termination of a candidate’s testing session and/or invalidation of
the candidate’s exam score.

Testing Center Procedures:

▪ Candidates must arrive at least 10 minutes prior to the scheduled start of the
exam. Late arrivals cannot be accommodated.
▪ Candidates must have one form of identification (the name on the identification
provided must match the name with which the candidate registered on the
National Board website):
1. A valid form of government-issued identification bearing the candidate’s
SIGNATURE and PHOTOGRAPH. Accepted forms of photo ID include:
driver’s license, state ID, passport, military ID card; no other forms of
photo identification will be accepted.
▪ No food or beverage is permitted in the examination area. Tobacco products and
chewing gum may not be used by candidates or proctors during exams.
▪ Personal Items: Please be advised that cell phones, pagers, cameras,
programmable electronic devices and recording devices of any kind are NOT
allowed. No desk accessories (e.g., family photos, “good luck” articles) or
personal items (such as handbags) are permitted in the exam area. No weapons
or instruments that may reasonably be used as weapons may be brought into
the examination area.
▪ Authorized Materials for the Oral Exam: One non-electronic (paper) bi-lingual
dictionary is allowed in the testing room. Blank white paper for note taking is

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allowed but all paper must be given to the proctor at the end of the exam for
shredding. Please bring at least two pens or pencils with you for note taking.
▪ Authorized Materials for the Written Exam: None
▪ You are not allowed to take breaks, stand up or move around during the exam.
You will not be allowed to leave the testing area until you finish and submit the
exam.
▪ If you experience any problems during the testing, you must document these
problems with the testing center personnel BEFORE you leave the testing site
and contact the National Board via email notifying us of the issue within 24
hours.

Exam Security:
▪ You will be observed at all times during testing and should be aware that
security procedures are in place and will be enforced. Failure to follow
instructions will result in your application being voided and forfeiture of your
application fee. Conduct that results in violation of security will result in the
disqualification of examination results and may lead to legal action. Examples of
misconduct include, but are not limited to, the following: writing on anything
other than the authorized scratch paper provided to you, looking at another
computer monitor, or talking with others at any time during the entire
examination period.
▪ Please be advised that all examination content is strictly confidential. You may
not copy any portion of the examination for any reason. No exam materials,
documents, or notes of any sort are to be taken from the examination room
under any circumstances.
▪ You may not communicate with anyone except the proctor during the exam. No
questions concerning the content of the examination may be asked in the
examination room before, during, or after the exam. Proctors are not allowed to
answer any questions about the content of the examination. Proctors may
answer questions about processes (e.g. time limit), but cannot interpret or
explain any words or information on the exam. At no other time, before, during
or after the examination, may you communicate orally, electronically or in writing
with any person or entity about the content of the examination or individual
examination questions.
▪ In most cases, those taking the oral exam will be in a room by themselves. Cell
phones are not permitted in testing areas. No unauthorized persons will be
admitted into the testing area. All candidates are expected to answer the exam
questions independently. There is to be no sharing of information, teamwork, or
any other collaborative relationship with another candidate during the exam. Any
violation of this policy is considered to be cheating. Any candidate engaged in
this behavior may be subject to score cancellation and not be allowed to sit for
future administrations of the exam.

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▪ For the oral exam you may use blank white paper on which to take notes using a
pencil or pen. Any scratch paper or other exam materials must be shown to the
proctor at the end of the exam for proper disposal. These materials are not
permitted for the written exam.

Cheating
Individuals suspected of cheating will be subject to the National Board disciplinary
policies and procedures.

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After the Exams

Written Exam Results

Whether testing online or at a testing center, candidates receive their written exam
results within 24 hours. After a candidate passes the written exam, they are sent
instructions on how to order their Hub-CMI certificate, order a badge, and schedule
their oral exam, if applicable. Candidates who interpret languages for which there is no
CMI program are not eligible to take the oral exam.

Oral Exam Results

Candidates will receive pass/fail notification, their score, and general feedback on their
performance by email from the National Board approximately 8-10 weeks following their
test session.

Oral exams are evaluated based on:

1. Accuracy – conveying the meaning without omissions, additions, summarizing or

editorializing any information and retaining the original register
2. Listening and information retention skills – following instructions and retaining in
memory the most important information to recall when providing the interpreted
rendition
3. Grammar – using correct syntax and usage, and avoiding the use of false
cognates (words that sound like they should be correct, but are not), like
constipado (in Spanish this means having a cold) for constipated
4. Interpreting style – displaying consistently good enunciation, intonation and
pronunciation, as well as a courteous and professional demeanor
5. Knowledge of terminology and specialties – demonstrating knowledge of a wide
range of health care specialties and medical terminology

Understanding Your Score Reports

The passing scores for the written and oral exams were established through a standard
setting study for each of the exams. Subject matter experts rated each item using a
modified Angoff procedure. After the pilot testing phase, PSI’s professional testing staff
conducted psychometric analyses of the resulting item bank to derive a recommended
passing score for the oral and written exams, designed to ensure safe and competent
practice as a medical interpreter. This means that each candidate’s performance on the
exam is measured against a predetermined standard.

Candidates are not graded on a curve and do not complete against each other or
against a quota. Receiving a higher than passing score is not an indication of more
advanced knowledge or a predictor of better job performance. All individuals who pass

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the exam, regardless of their score, have demonstrated an acceptable level of

knowledge.

Retesting
Candidates who do not pass the written or the oral exam may re-take the respective
exam after a 3-month waiting period. The initial exam and re-test fees and application
procedures are the same. After 3 retakes you will be permitted 1 attempt per calendar
year. You may take the written exam online once, but for all additional exams you are
required to test at a testing center.

Examination Appeals
The National Board consistently evaluates the examinations to ensure they accurately
measure competency in the required knowledge areas. While taking the exams,
candidates had the opportunity to provide comments on any questions. All substantive
comments will be reviewed.

Candidates who fail the oral and/or written exam may file an appeal if they believe the
exam failure is a result of:

▪ Examination scoring/grading errors;

▪ Inappropriate exam administration procedures that violate National Board policy;
or
▪ Testing conditions severe enough to cause a significant disruption of the
examination process (including environmental conditions, disruptions caused by
other candidates).

Examination appeals must be submitted in writing within 30 days of receipt of

notification of an adverse exam decision. Any incident occurring during exam
administration should be reported to the proctor immediately and to the program
advisor, or directly at [email protected] within 24hrs hours of the
test.

The National Board reviews exam appeals by email within thirty (30) days of receipt of
the appeal. All appeals should be sent to [email protected]. The
examination appeal must provide the candidate’s name, testing location information,
and date of the exam.

Notice of the final determination shall be provided to the appellant within ten (10)
business days of the decision. The determination of the Board of Directors of the
National Board will be final.

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Maintaining Credentials

In order to promote professional development for Hub-CMIs and CMIs, the National
Board requires renewal every 4 years for Hub-CMIs and every 5 years for CMIs. The
renewal requirements have been developed to promote maintenance of the skills and
knowledge required for competent medical interpretation and to provide an opportunity
for interpreters to strengthen and expand their knowledge and skills. To achieve this
purpose continuing education units are only accepted for training directly related to
medical interpretation.

By requiring your credential to be renewed, the National Board protects patient’s safety,
honors patient’s right to obtain services of a competent interpreter, and prevents
interpreters certified in the past to lag on field experience.

In establishing a renewal time period, the National Board considered the need for
ongoing professional development in terms of skill maintenance and knowledge
expansion, while also considering the relative stability of medical terminology as well as
the constancy of language skills over time. The National Board determined that while
continual professional development is essential, the pace of change in the field of
medical interpreting is relatively slow. Based on these factors the National Board has
determined that a 4-year renewal cycle for Hub-CMI and a 5-year renewal cycle will
best promote continuing professional development.

Renewal Requirements
To maintain the credential all Hub-CMIs must renew every 4 years and CMIs every 5
years, by participating in education directly related to medical interpretation.

Please Note: If there is an oral exam available in the Hub-CMI’s target language, the
Hub-CMI will expire in 2 years with no option for renewal.

▪ Hub-CMIs/CMIs must renew by completing 3 CEUs (Continuing Education Units),

equivalent to 30 contact hours of approved training before the credential’s
expiration date (4 years from initial Hub-CMI date of credential or 5 years from
initial CMI date of certification).
▪ Each CEU is equal to 10 contact hours of training (not counting meals, breaks,
etc.) by most organizations. For example, a typical conference day is 0.6 CEUs.
▪ Individuals who fulfill this requirement will not need to retake the NBCMI exams
to maintain their Hub-CMI/CMI credential (see Failure to Renew section below).

Hub-CMI/CMIs are strongly encouraged to earn CEUs throughout the 4-year period
(Hub-CMI) or 5-year period (CMI).

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All continuing education must be related to interpreting skills/ability and

medical knowledge.

Fees & Deadlines

The renewal application fee of $300 with all documentation must be submitted at least
45 days before the expiration date of one’s Hub-CMI/CMI credential.

Hub-CMIs may complete 1.5 CEUs (Continuing Education Units), equivalent to 15

contact hours in the first two years and submit payment of $150; and 1.5 CEU’s in the
subsequent 2 years, with a second payment of $150. If a Hub-CMI waits until the last
year to renew the Hub-CMI, the payment will be $300 and he/she will be required to
submit 3.0 CEUs (30 hours) by the end of the 4-year period.

Extensions
National Board allows Hub-CMIs/CMIs to request a renewal extension for no more than
6 months. The request must include the time frame for which the extension is being
requested and a plan describing the courses of study that will be taken to fulfill the
requirement. Extension requests should be submitted 30 days prior to the Hub-CMI/CMI
expiration date to the National Board staff email account
([email protected]).

A National Board staff member will contact the Hub-CMI/CMI within 10 business days
with determination. If the extension is approved, the Hub-CMI/CMI will be required to
pay the recertification fee and the expiration date will be extended. Once the CEUs are
approved, the new expiration date will be set for 4 years (Hub-CMI) or 5 years (CMI)
from the original expiration date (not the extension date).

If the Hub-CMI/CMI fails to meet the CEU requirements during the extension time
granted, the Hub-CMI/CMI credential will expire. A Hub-CMI who is not eligible for the
oral exam will only be required to re-take the written exam. A Hub-CMI who is eligible
for the oral exam and CMIs will be required to retake the written and oral exams to
reinstate the Hub-CMI/CMI credential. The renewal fee is non-refundable.

Documentation Required
Certificants are responsible for obtaining and retaining appropriate documentation for
all CEU activities. The following documentation will be required along with the
recertification application:

1. Confirmation of attendance signed by the instructor or host/sponsoring

organization.
2. Event registration confirmation (or copy of event registration).

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At least one of the items above must include the title and date of the training event. If
the title does not clearly indicate the subject matter of the training, the certificant
should also retain a syllabus, outline, handouts, or other similar documents.

Acceptable Continuing Education

The National Board automatically accepts IMIA CEUs. The IMIA CEUs must be for
workshops, conferences, and events that are related to medical interpreting knowledge
and skills enhancement.

Education opportunities other than those provided by IMIA may be reviewed and
evaluated by the National Board upon request. Conference workshops can be accepted
as long as the schedule has been signed or initialed by the presenter with dates and the
Hub-CMI/CMI’s name being visible on the page. The conference attendance certificate
must also be presented.

In order for a learning activity to be quantified as Continuing Education, there must be

a demonstrated benefit for the successful attendee that enhances their skills as a
medical interpreter. The Hub-CMI (within the 4-year credentialing period) and the CMI
(within the 5-year credentialing period) should accumulate at least 1 CEU (10 hours) of
the required 3 CEUs (30 hours) through activities focusing on standards of practice, the
code of ethics for the certified medical interpreter, etc. and at least 1 CEU (10 hours)
focusing on skill development (memory enhancement, note taking, sight translation).
This last requirement helps minimize the limitation of just counting conference hours of
attendance to suffice as continuing competence in the medical interpreting field.

Acceptable Continuing Educational opportunities for the Hub-CMI/CMI may include but
are not limited to:

▪ activities designed to increase the skills and/or knowledge of practicing certified

medical interpreters such as online self-paced learning activities, webinars (live
and recorded) workshops, and conference events
▪ college courses which contribute to the increased knowledge of the interpreter
(terminology, anatomy, etc.)

The following activities cannot be accepted:

▪ beginning level courses that would be taken by individuals seeking to become a

Hub-CMI/CMI
▪ mandatory policy trainings by hospitals or clinics that are part of employment
▪ court and legal interpreting
▪ translating

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Hub-CMIs and CMIs should be taking advanced trainings that are more in line with their
skill set than just a beginner’s training. Since the National Board gives a credential for
medical interpreting, the only court, legal and translation activities that can be accepted
MUST relate directly to medical interpreting.

Renewal Procedures
The first step for the Hub-CMI/CMI is to go is to visit the National Board website and
review information about paying the $300 recertification fee and how to submit CEUs.

When a payment is received, the website generates a receipt which is forwarded to the
registrar, who finds the online profile of the Hub-CMI/CMI and reviews the CEUs. The
Hub-CMI/CMI will receive a reply in about two weeks, depending on the number of
certificates to be reviewed in the file.

If approved, the registrar updates the Hub-CMI/CMI’s online profile with the new
expiration date and sends a congratulatory email with instructions on how to order a
badge and receive his/her electronic certificate.

If the CEU review by the registrar is not complete, the Hub-CMI/CMI receives a
message with instructions on what steps are needed to finalize the process.

All Hub-CMI/CMI questions about renewal should go to the staff email account
([email protected]).

Appeals Process for Renewal CEUs

Hub-CMIs/CMIs whose CEUs are not accepted toward renewal may appeal this decision
by sending a message to [email protected]. The appeal should
include an appeal letter from the applicant clearly stating why they believe the decision
was wrong.

The appeal should be sent to [email protected] within 30 days of

receipt of notification of the adverse decision. The National Board reviews exam appeals
by email within thirty (30) days of receipt of the appeal. Notice of the final
determination shall be provided to the appellant within ten (10) business days of the
decision. The determination of the Board of Directors of the National Board will be final.

Failure to Renew
Credentialed interpreters who do not comply with the renewal requirements before the
established deadline every fourth year (Hub-CMI) or fifth year (CMI) will lose their
credential(s) and will be removed from the registry of Hub-CMIs/CMIs. To regain their
credentials, lapsed individuals must re-apply for the credential, meet the prerequisite
requirements in effect at the time, and pass the examination requirements.

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Policies

Special Accommodations
The National Board is committed to equal access for all certification candidates and
complies with the Americans with Disabilities Act. Reasonable examination
accommodations will be made at no extra charge to individuals with documented
disabilities.

Appropriate accommodations will be provided to qualified candidates with disabilities to

the extent that such accommodation does not fundamentally alter the examination, or
cause an undue burden to the NBCMI or the agency administering the examination.
Information regarding a disability will be considered strictly confidential and will only be
shared with the testing sites who will administer the test.

Requesting Accommodations
The National Board is not required to provide accommodations if unaware of a
candidate’s needs. It is the responsibility of candidates with disabilities to notify NBCMI
in writing of the applicant’s need for an accommodation.

There are two ways to notify the National Board of the ADA accommodation request:

▪ If a special need or disability is present at the time of submitting the

registration, the candidate should add the pertinent information under
“Special Accommodations” on the registration form. If accepted to the
program, the candidate will be directed to explain the nature of their
request and to upload necessary documentation. It is the candidate’s
responsibility to submit the pertinent supporting documentation in
electronic format.
▪ If a special need or disability arises after the applicant has already been
approved to take an exam, the candidate must submit the Special
Accommodation Request Form (Appendix A) to their program advisor or
[email protected], or complete the form on the
National Board website, along with the supporting documentation.

All accommodation determinations will be made by the NBCMI at its discretion. Failure
to notify NBCMI of needed accommodation(s) at the registration or at least 30 days
before scheduling an exam may result in the accommodations not being available at the
time of the examination.

Candidates shall not hold the NBCMI accountable for any lack of appropriate
accommodation deriving from the applicant’s/candidate’s own failure to notify the
NBCMI of their needs on a timely basis. Once special accommodations have been
granted, they may not be altered during the examination.

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The Role of the Human Reader/Actuator

A candidate may request a human reader and/or human actuator for a written exam or
an oral exam. The human reader and/or human actuator is one person who may
perform either the role of human actuator, the role of human reader, or both roles.

The candidate must specify whether they are requesting a human reader, human
actuator, or both. There is not an extra charge associated with providing a human
reader and/or actuator.

A human reader and/or human actuator CANNOT be a current candidate for the CMI
credential. A candidate CANNOT bring their own human reader and/or human actuator.
The NBCMI has sole discretion to nominate an individual as a human reader and/or
human actuator.

A human reader is an individual who can read, write, speak and understand English
with the proficiency and command of the English language and will assist a candidate
with the written exam. The role of the human reader is to read words from the
computer screen to the candidate. The human reader cannot resolve, explain, or
provide assistance other than the task of reading.

A human actuator is an individual who is able to operate a keyboard and mouse. This
individual can read, speak, and understand English. The role of the human actuator is
to navigate through a computer-based test by operating a keyboard and mouse. The
human actuator cannot resolve, explain, or provide assistance other than the task of
navigating throughout the test by operating a keyboard and mouse.

The Role of the Proctor

A proctor is the individual administering the examination at the designated testing
center. A proctor CANNOT also serve as the human reader and/or human actuator for
the same examination administration. A testing center’s proctor may serve as a human
reader and/or human actuator if a second proctor is available to proctor the
examination, but at no time may any person serve as proctor and also have another
role (human actuator/reader) for the same exam.

Written Exam Accommodations

Candidates taking the written exam should contact NBCMI to request accommodations
prior to scheduling an exam session.

The following requests may be granted if needed: Larger font, modification of seating
or other physical arrangements in the examination facility, providing for the
examination to be taken in an accessible location; or providing for a reasonable
extension of testing time (the written exam takes approximately 45 minutes; the NBCMI
will increase 30 minutes over the total exam time, exclusive of initial instructions).

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The following requests will be denied: changes of the content of the exam; providing
for unlimited testing time; permitting a reader to paraphrase test material or translate
the material into another language.

If requested, the NBCMI will authorize a human reader and/or human actuator and
extended time as a reasonable accommodation to those individuals who otherwise meet
the eligibility requirements to take the written examination. The NBCMI has sole
discretion to nominate an individual as human reader and/or human actuator. There is
not an extra charge associated with providing a human reader or additional time for
examination administration.

Written Examination Process

Prior to the proctor logging the candidate in to begin the examination process, a human
reader/actuator, if present, will introduce him/herself to the candidate and explain what
their role entails.

The human reader will inform the candidate that the candidate may, at any time during
the examination administration, ask the reader to speed up or slow down, to read
louder or softer. The human reader will read aloud all instructions. Questions that the
candidate may have about the instructions must be directed to the attending proctor, as
is the current policy for all candidates.

No candidates, either with or without a human actuator, are allowed breaks during
examination.

Oral Exam Accommodations

The following requests may be granted if needed: Larger font, modification of seating
or other physical arrangements in the examination facility, providing for the
examination to be taken in an accessible location.

The following requests will be denied: changes of the content of the exam; providing
for unlimited testing time; permitting a reader to paraphrase test material or translate
the material into another language, extension of testing time (the oral exam has a pre-
set recording time).

If requested, the NBCMI will authorize a human reader and/or human actuator and
extended time as a reasonable accommodation to those individuals who otherwise meet
the eligibility requirements to take the oral examination. The NBCMI has sole discretion
to nominate an individual as human reader and/or human actuator. There is not an
extra charge associated with providing a human reader/actuator.

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Oral Examination Process

Prior to the proctor logging the candidate in to begin the examination process, a human
reader/actuator, if present, will introduce him/herself to the candidate and explain what
their role entails.

The human reader will inform the candidate that the candidate may, at any time during
the examination administration, ask the reader to speed up or slow down, to read
louder or softer. The human reader will read aloud all instructions. Questions that the
candidate may have about the instructions must be directed to the attending proctor, as
is the current policy for all candidates.

The candidate has the responsibility to direct the human actuator to perform any
actions required to progress through and complete the examination. The candidate and
the human actuator must both read the examination instructions carefully and ask the
proctor any questions either of them may have. The candidate is encouraged to
perform the practice test prior to the exam to be familiar with the format of the oral
examination.

On the sight translation, the human actuator will first read the entire passage (90
seconds for this part), and then when the recording of the response begins, the human
actuator will read it line by line giving the candidate a chance to interpret between each
line – the candidate will have 4 minutes for this part.

On the mini-scenarios, the human actuator will cue the candidate when the recording
automatically starts. There is an 8 second "think time" pause between the utterance
that the candidate will have to interpret and when the recording automatically starts. If
the candidate does not want to wait the 8 seconds, s/he may cue the human actuator
to click on "Record" and begin the response immediately.

If the candidate wants a repetition, s/he will tell the proctor immediately after hearing
the utterance s/he wants repeated (and during the 8 seconds of "think" time) and the
human actuator will click on the play button to get the repetition. The candidate will
have 6 chances to do so during the entire test.

The candidate is entirely responsible for managing the time allotted to take the
examination, and must complete the examination within the allotted time. No additional
time will be provided.

No candidates, either with or without a human actuator, are allowed breaks during
examination.

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Nondiscrimination
The National Board prohibits discrimination on the basis of race, color, sexual
orientation, gender identity or expression, age, disability, national origin or citizenship
status, marital status, religion, or any other basis prohibited by law.

Confidentiality
The National Board is committed to protecting confidential applicant and certificant
information as well as confidential information regarding examination development and
administration processes.

Information about applicants/certificants and their examination results is confidential.

Exam scores will be released only to individual candidates, unless a signed release is
provided. Personal information submitted by applicants/certificants with an application
for initial certification or recertification is confidential. Personal information retained
within the applicant/certificant database will be kept confidential.

The National Board will not disclose confidential applicant/certificant information unless
authorized in writing by the individual or as required by law.

The names of National Board certified individuals are not considered confidential and
may be published by the National Board.

Aggregate exam statistics (including the number of exam candidates, pass/fail rates,
and total number of certificants) will be publicly available. Aggregate exam statistics,
studies, and reports concerning applicants /certificants will contain no information
identifiable with any applicants/certificants, unless authorized in writing by the
individuals.

Use of the Credentials

The use and/or display of the National Board or Hub-CMI/CMI name, and National
Board logo, except as permitted by this policy, requires the written consent of the
National Board. Use of the National Board name and/or logo to state or imply approval
or affiliation with the National Board is prohibited except as permitted by this policy.
The Hub-CMI/CMI name and logo may only be used as permitted by this policy and in
connection with a certified individual and not with a company or group of individuals.

Individuals who fail to renew or whose Hub-CMI credential or CMI certification is

suspended or revoked must immediately discontinue use of the National Board name
and are prohibited from stating or implying that they hold the Hub-CMI credential or
CMI certification.

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Acceptable Use
Individuals who have earned the CMI certification may identify themselves as a National
Board certified medical interpreter. For the Hub-CMI credential, interpreters may
identify themselves as Hub-CMI with no language designation added. For example,
Hub-CMI. For the CMI, the proper language designation, will be added, for example:
CMI-Spanish.

CMI–Spanish. The individual must always specify the certified language along with the
CMI designation. Proper specification is CMI followed by a hyphen and then the
language(s) certified.

Individuals must maintain their Hub-CMI credential or CMI certification in good standing
to continue to use the name. The Hub-CMI or CMI name may be used only as long as
the credential/certification is valid. Both the Hub-CMI credential and the CMI
certification are non-transferable, revocable, limited, non-exclusive licenses to use the
designation “Hub-CMI” or “CMI,” and are subject to compliance with the policies and
procedures of the Board, which may be revised from time to time.

Name
Hub-CMI credentialed and CMI certified individuals may not make misleading,
deceptive, or confusing statements regarding their credential or certification. For
example, individuals may not suggest that they have interpreting ability or other
professional expertise outside of the scope of their professional licenses, credentials,
and formal education and training.

Certificate
Each Hub-CMI credentialed interpreter and CMI certified individual will receive an
electronic certificate. Each certificate will include an expiration date. Individuals who
renew their credential/certification (renew) will receive a new certificate. All certificates
remain the sole property of the National Board and must be returned if the individual’s
credential/certification is suspended or revoked.

Complaints and Investigations

Incidents of alleged misuse of the National Board and/or Hub-CMI/CMI name and/or
logo by a certificant or applicant will be investigated by the National Board according to
the complaints and disciplinary policy.

Disciplinary Policy & Procedure

In order to maintain and enhance the credibility of the Hub-CMI credential and the CMI
certification programs, the National Board has adopted the following procedures to
allow individuals to bring complaints concerning the conduct of individuals who are
Hub-CMI/CMI candidates or certificants to the National Board.

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In the event an individual candidate or certificant violates the Hub-CMI/CMI certification

rules or the National Board’s policies, the National Board may reprimand or suspend the
individual or may revoke certification.

The grounds for sanctions under these procedures may include, but are not necessarily
limited to:
1. Violation of recognized standards of practice and codes of ethics in the field of
medical interpreting published by the International Medical Interpreter
Association (IMIA), the National Council on Interpreting in Health Care (NCIHC)
and the California Healthcare Interpreting Association (CHIA).
2. Violation of established National Board policies, rules and requirements.
3. Conviction of a felony or other crime of moral turpitude under federal or state
law in a matter related to the practice of, or qualifications for, medical
interpretation.
4. Gross negligence, willful misconduct, or other unethical conduct in the
performance of services for which the individual has achieved a National Board
Hub-CMI credential or CMI certification.
5. Fraud or misrepresentation in an initial application or application for
recertification.
6. Fraud or misrepresentation of the Hub-CMI credential or CMI certification.

Information regarding the complaint process will be available to the public via the
National Board web site or other published documents. A complete copy of this policy
will be made available to any individual upon request.

Actions taken under this policy do not constitute enforcement of the law, although
referral to appropriate federal, state, or local government agencies may be made about
the conduct of the candidate or certificant in appropriate situations. Individuals initially
bringing complaints are not entitled to any relief or damages by virtue of this process,
although they will receive notice of the actions taken.

Complaints
Complaints may be submitted by any individual or entity. Complaints should be reported
to National Board in writing and should include the name of the person submitting the
complaint, the name of the person the complaint is regarding along with other relevant
identifying information, a detailed description of factual allegations supporting the
charges, and any relevant supporting documentation. Information submitted during the
complaint and investigation process is considered confidential and will be handled in
accordance with National Board’s confidentiality policy. Inquiries or submissions other
than complaints may be reviewed and handled by the National Board or its staff
members at its discretion.

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A complete copy of the National Board Disciplinary Policy is contained in the National
Board Policies & Procedures Manual. The full disciplinary policy is available upon request
from the National Board office.

Appeals
Within thirty (30) days from receipt of notice of a determination by the National Board
that a candidate/certificant violated the certification program policies and/or rules, the
affected candidate/certificant may submit to the National Board in writing a request for
an appeal.

A complete copy of the National Board Disciplinary Policy that includes the appeal
procedures is available upon request from the National Board office.

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Appendix A: Special Accommodation Request Form

DIRECTIONS

Please submit this form along with any required accompanying documentation,
electronically to [email protected]. If you are requesting
accommodation(s), your application will not be considered complete until this form
and any required accompanying documentation is submitted. Any delay in
submitting this form may affect the timeline for determining your eligibility.

CANDIDATE INFORMATION
First Name:

Last Name:

Date:

Address:

E-mail:

SPECIAL ACCOMMODATIONS
Please describe your disability:

Will this disability require special accommodations in order for you to take the
examination? YES NO

If Yes, please describe the specific testing accommodations you are requesting:

Include separately any written documentation supporting the accommodation that

you are requesting.

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