Thread_1444384 Nursing CAP Documentation Submission Form

Nursing CAP Documentation Submission Form
Complete Member Information
Name*

First NameLast Name
CNMC Employee Number*
CNMC email*

Confirmation EmailVERIFY THIS EMAIL IS CORRECT. THIS EMAIL WILL BE USED TO SEND LINK WHERE YOU CAN ADD DOCUMENTATION REQUIREMENTS.
I am applying for CAP Level*
Level 1-3
Clinical Exemplar*

Browse Files

Cancelof
Applicant/Manager Attestation*

Browse Files
Attach completed signature page here. Cancelof

Submit Part A & B Requirements
Total Points
Total Points is READ ONLY (Automated Calculation)
Minimum criteria to submit nursing CAP portfolio has not been met.
My Nursing CAP portfolio (level 1) is complete.

Yes
My Nursing CAP portfolio (level 2) is complete.

Yes
My Nursing CAP portfolio (level 3) is complete.

Yes
Yes to Proceed*

Yes
Send portfolio to*
Enter nursingcap@childrensnational.org
Click Submit CAP Requirements button below if you are complete with your documentation requirements and ready to submit CAP portfolio for approval. Once you click Submit CAP Requirements you will not be able to edit your CAP portfolio.

Click on tabs on top of the page to go directly to the section desired.

Approval Status

(FOR USE BY NURSING CAP STEERING COMMITEE ONLY)
Calculated Based on fields filled
Total Points Accumulated Part A + Part B Requirements
Auto Calculated based on the submitted requirements. This field is read only. Total points required: Level 1 (7 pts); Level 2 (14 pts); Level 3 (21 pts)
Type in Security Code
Nursing CAP portfolio is approved.

YesNo
Approved by (Name of Nursing CAP Steering Committee Member)*
Date Approved *

MonthDayYear
Reason not approved*
Yes to Proceed*

Yes
Click Submit/Close Form when you are complete. This will then send an automated email to nurse applicant informing them whether their CAP submission is approved or not.

Click on tabs on top of the page to go directly to the section desired.
Should be Empty: