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It covers attestation language, selection of the AANPCB examination, designation of a single provincial regulator for result delivery, and required candidate signature and date details. It also explains confidentiality rules for candidate testing and results.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/disclosure-of-candidate-information-form-submission-and-attestation-for-aanpcb-certification-exam/326685/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/disclosure-of-candidate-information-form-submission-and-attestation-for-aanpcb-certification-exam/326685.png","ImageObject",300,407,{"name":42,"@type":43},"Rhys","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-21",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Who must receive the examination results under this form’s authorization?","Question",{"text":62,"@type":63},"The form grants permission for AANPCB to release personally identifiable information about exam results to the candidate’s provincial regulator, including pass/fail and other performance details if unsuccessful.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"What must candidates do if they are rewriting the exam after an unsuccessful attempt?",{"text":67,"@type":63},"Candidates rewriting the exam after an unsuccessful attempt must complete remediation before submitting this form. 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Box 12926, Austin, TX, 78711-2826 Overnight Delivery: 2600 Via Fortuna, Ste. 240, Austin, TX, 78746  \nImportant Information:  \n• Candidates re-writing this exam after an unsuccessful attempt must complete remediation before submitting this form. For the Adult-Gerontology Primary Care NP Exam, read the candidate fact sheet for details.  \n• Please submit this completed form to the regulatory body checked below. Do not submit this form directly to AANPCB.  \n\n| ATTESTATION |  |  |\n| --- | --- | --- |\n| | I certify by typing my signature below that I grant permission to the American Academy of Nurse Practitioners National Certification Board (AANPCB) to release personally identifiable information regarding my exam results, which will include the pass/fail result, the scaled score and, if unsuccessful, the performance by exam domain, to my provincial regulator.\u003Cbr>I understand that these results will be sent to my provincial regulator by email. I understand that AANPCB will only send me my official result (by postal mail service) if it has received my official university transcript. |  |\n| AANPCB CERTIFICATION EXAMINATION |  |  |\n|  | Notify the following regulator that I have taken the AANPCB certification examination.\u003Cbr>□ Adult-Gerontology Primary Care Nurse Practitioner Exam □ Family Nurse Practitioner Exam |  |\n| PROVINCIAL REGULATOR\u003Cbr>Please indicate the provincial regulator to which the examination results are to be released. Select only one regulator. |  |  |\n| |  British Columbia College of Nurses and Midwives\u003Cbr>Email to: [register@bccnp.ca](register@bccnp.ca) |  |\n|  |  College and Association of Registered Nurses of Alberta\u003Cbr>Email to: [nursepractitioners@nurses.ab.ca](nursepractitioners@nurses.ab.ca) |  |\n|  |  Saskatchewan Registered Nurses’ Association\u003Cbr>Email to: [register@srna.org](register@srna.org) |  |\n|  |  College of Registered Nurses of Manitoba\u003Cbr>Email to: [registration@crnm. mb.ca](registration@crnm. mb.ca) |  |\n|  |  College of Nurses of Ontario\u003Cbr>Email to: [cno@cnomail.org](cno@cnomail.org)\u003Cbr>Write in subject line: “NP Exam Consent Form” |  |\n|  |  Nova Scotia College of Nursing\u003Cbr>[Email to:](Email to: registration@nscn.ca)[ ](Email to: registration@nscn.ca)[registration@nscn.ca](Email to: registration@nscn.ca) |  |\n|  |  Association of Registered Nurses of Newfoundland and Labrador\u003Cbr>Email to: [registration@arnnl.ca](registration@arnnl.ca) |  |\n|  |  Registered Nurses Association of Northwest Territories and Nunavut\u003Cbr>Email to: [info@rnantnu.ca](info@rnantnu.ca) |  |\n|  |  Ordre des infirmières et infirmiers du Québec\u003Cbr>Email to: [nadine.fournier@oiiq.org](nadine.fournier@oiiq.org) |  |\n| SIGNATURE |  |  |\n|  | Candidate Signature: | Date: |\n|  | Print Name: |  |\n\nConfidentiality of Information:  \nInformation collected by AANPCB about candidates for testing purposes and their examination results are confidential and will not be released except with the specific written authority of the candidate. Studies and reports concerning candidates will contain no information identifiable with any candidate.","cbCaih7iSdguOJeR","https://ap.wps.com/l/cbCaih7iSdguOJeR","pdf",235188,"English","# Form Overview\n## Submission Instructions\n## Attestation and Consent\n## Examination Notification\n## Provincial Regulator Selection\n## Signature and Date\n## Confidentiality of Information","[{\"question\":\"Who must receive the examination results under this form’s authorization?\",\"answer\":\"The form grants permission for AANPCB to release personally identifiable information about exam results to the candidate’s provincial regulator, including pass/fail and other performance details if unsuccessful.\"},{\"question\":\"What must candidates do if they are rewriting the exam after an unsuccessful attempt?\",\"answer\":\"Candidates rewriting the exam after an unsuccessful attempt must complete remediation before submitting this form. For the Adult-Gerontology Primary Care NP Exam, they must read the candidate fact sheet for details.\"},{\"question\":\"How does a candidate choose the provincial regulator for result release?\",\"answer\":\"The candidate must indicate the provincial regulator where results should be released and select only one regulator from the listed options.\"}]","DISCLOSURE OF CANDIDATE INFORMATION FORM - Submission and Attestation for AANPCB Certification Exam | PDF",1789975076]