FOR SUBMISSION TO CSCPF ONLY BY A PRACTITIONER COMMUNITY CERTIFICATION REVIEW REPRESENTATIVE
To the Practitioner Community Certification Review Representative:
This Notice of Decision form is very simple, because the candidate will have already undergone all required steps in the process for new or reciprocal certification. Your submission of this form is the means by which you document the decision of the Certification Review Board, on behalf of your Practitioner Community, that the candidate has met all the requirements of each category and is otherwise properly formed and ready to receive the requested certificate.
Please note that an actual certificate will not be issued until the candidate's membership in CSCPF has been reviewed and is in good standing. Upon receipt of this request, the candidate's profile on the CSCPF Member Directory will be updated accordingly but which they themselves cannot change.
Please note: The conditions associated with a provisional approval must be specified in the Report of the Practitioner Community.
If you have any questions, please call 925-658-5740 option 4.
- Report of the Community (Upload PDF or enter below) All certifications.
- Report of the Candidate (Upload PDF or enter below) New certifications only.
- Report of the Review Liaison (Upload PDF or enter below) New certifications only.
- Certification Review Decision Summary (Signed, upload PDF) All certifications.
PLEASE NOTE: You must click on the arrow icon on the right side of each shaded grey area to open it