National Council of Post-Acute Care Practitioners

Contact Us

    A. Biography

    Full Name:

    Credentials (Example: RN, MSN):

    Home Address:

    Personal Email:
    Personal Phone:
    Work Email:
    Work Phone:

    Date of Birth: (YYYY-MM-DD)

    B. Education

    College / University:
    Year Graduated:
    Degree:

    College / University:
    Year Graduated:
    Degree:

    College / University:
    Year Graduated:
    Degree:

    C. Certification & License

    Nurses:

    License Number
    State
    Active?

    Other Health Care Professionals
    State
    Active?

    D. Employment (Nurses)
    Are you a self-employed consultant?
    total hours of consulting work per week

    Name of Organization/ Employer:
    Work Address:

    Length of Employment: to
    current position or title:

    Check One:

    Check One:

    E. Post-Acute Care Training/Work Experience (Nurses)

    Describe your current and past duties/experiences:

    Supervisor Name and Job Title:
    Supervisor email address:
    Supervisor Phone number:

    F. Employment (Other Health Care Professionals)

    Name of Organization/ Employer:
    Work Address:

    Length of Employment: to (YYYY-MM-DD)

    G. NCPACP Post-Acute Care Certified Staff Educator Seminar

    Date of Seminar (YYYY-MM-DD)
    Location: City/State
    Instructor Name
    Course Number

    H. Code of Ethics for PAC-CSE
    I have received, read and agree to abide by the NCPACP Code of Ethics for Post-Acute Care Certified Staff Educators. I attest with my signature below that I have retained copy of the code.

    Digital Signature
    Date (YYYY-MM-DD)

    National Council of Post-Acute Care Practitioners NCPACP
    Code of Ethics for Post-Acute Care Certified Staff Educators (PAC-CSE)

    1. The PAC-CSE provides service to the health care profession with respect and dignity to the Post-Acute Care Client.
    2. The PAC-CSE recognizes and respects the Post-Acute Care Client individuality.
    3. The PAC-CSE participates in ongoing education and stays current with regards to Post Acute Care issues and the National Council of Post-Acute Care Practitioners/ Institute of Post-Acute Care Practitioners recommended topics listed in the body of Knowledge.
    4. The PAC-CSE maintains competence in his chosen profession.
    5. The PAC-CSE will report to the National Council of Post-Acute Care Practitioners/ Institute of Post-Acute Care Practitioners any acts by a Certified Post-Acute Practitioner that is illegal or unethical.
    6. The PAC-CSE assumes absolute responsibility for your own individual actions.
    7. The PAC-CSE will stay current with certifications with the National Council of Post-Acute Care Practitioners/ Institute of Post-Acute Care Practitioners.
    8. The PAC-CSE ensures the privacy of the Post-Acute Care Client and applies all HIPPA Regulations.
    9. The PAC-CSE works to implement innovative ideas to the health care setting/ agency that may help a Post-Acute Care Client.
    10. The PAC-CSE works to ensure that quality of life is provided for the Post-Acute Care Clients residing in your health care setting or agency.
    11. The PAC-CSE networks with other health care professionals, attends Post-Acute Care Seminars, conventions, Support Groups and Ethics Committees.
    12. The PAC-CSE respects the Post-Acute Care Clients customs, religious beliefs, and philosophy.
    13. The PAC-CSE is truthful and avoids providing false or misleading Information.
    14. The PAC_CSE will not use the National Council of Post-Acute Care Practitioners / Institute of Post-Acute Care name and or logo on any brochure or advertising without the express permission of this organization and in no way benefit directly or indirectly at the expense of the National Council of Post-Acute Care Practitioners/ Institute of Post-Acute Care Practitioners.
    15. The PAC-CSE understands that its certification with the National Council of Certified Post-Acute Care Practitioners / Institute of Post-Acute Care Practitioners does not in any way confer upon the PAC-CSE any type of licensure as a health care provider.