Bedside renewal form 2026

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4.8 out of 5

210 votes

The document outlines the requirements for verifying bedside hours for the renewal of the Clinical Nurse Specialist (CSC) certification by the American Association of Critical-Care Nurses. It specifies that a clinical supervisor or professional colleague must confirm that the certificant has completed 432 hours of direct bedside care for critically ill adult cardiac surgery patients, with specific hour requirements within a designated time frame. The verifier is required to provide their contact information and sign the form to validate the information.

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Click ‘Get Form’ to open the bedside renewal form in the editor.
Begin by entering the 3-Year CSC Renewal Audit Period at the top of the form. This is crucial for tracking your certification timeline.
In the CERTIFICANT section, provide your name and ensure that a clinical supervisor or professional colleague will complete the verification section.
The verifier must confirm that you have completed 432 hours of direct bedside care. They should fill in their printed name, title, and signature in the designated fields.
Ensure all contact information for the verifier is accurately filled out, including their business email and phone number, as this may be needed for validation.
Review all entries for accuracy before saving or exporting your completed form to ensure a smooth submission process.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (210 Votes)

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