Denial, Suspension, or Revocation of Certification. The occurrence of any of the following actions will result in the denial, suspension, or revocation of Dermatology Nurse Practitioner Certification: (1) falsification of the DNPCB application; (2) falsification of any material information requested by the DNPCB; (3) any restrictions such as revocation, suspension, probation, or other sanctions of professional NP license by nursing authority; (4) misrepresentation of DCNP status; (5) cheating on the DCNP examination.
STATEMENT OF UNDERSTANDING
I hereby attest that I have read and understand the DNPCB policy on Denial, Suspension, or Revocation of Certification and that its terms shall be binding on all applicants for certification and all certified dermatology nurses for the duration of their certification. I hereby apply for certification offered by the Dermatology Nurse Practitioner Certification Board. I understand that certification depends upon successful completion of the specified requirements. I further understand that the information accrued in the certification process may be used for statistical purposes and for evaluation of the certification program. I further understand that the information from my certification records shall be held in confidence and shall not be used for any other purpose without my permission. To the best of my knowledge, the information contained in this application is true, complete, correct, and is made in good faith. I understand that the Dermatology Nurse Practitioner Certification Board reserves the right to verify any or all information on this application.
I also agree that my name and state may be published on the DNPCB website under "Find a DCNP" and may also appear on a congratulatory website banner.
Electronic Signature is acceptable.
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