2015 Candidate Examination Handbook

CPHQ Examination
Program Administered by the Healthcare Quality Certification Commission
of the National Association for Healthcare Quality

January 2015 by the Healthcare Quality Certification Commission

TABLE OF CONTENTS
Affiliation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Accredidation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Statement of Nondiscrimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Program Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Introduction to the CPHQ Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Examination Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Objectives of Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Definition of the Quality Professional . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Certification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Recertification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Eligibility Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
About the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
The CPHQ Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Examination Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Internal Examination Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Assessment Center Locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Holidays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Special Arrangements for Candidates with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Applying for and Scheduling an Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Rescheduling an Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Canceling an Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
No Refunds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Inclement Weather, Power Failure, or Emergency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Rules for Computerized Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Taking the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Identification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Assessment Center Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Personal Belongings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Examination Restrictions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Misconduct . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Copyrighted Examination Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Practice Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Timed Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Candidate Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Following the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Scores Canceled by HQCC or AMP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Disciplinary Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Pass or Fail Score Determination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
If You Pass the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
If You Fail the Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Duplicate Score Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Verification of Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Preparation for the CPHQ Certification Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
CPHQ Examination Content Outline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
CPHQ Examination Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Request for Special Examination Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Documentation of Disability-Related Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Request for Duplicate CPHQ Examination Score Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Request to Change Mailing or E-Mail Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

It is the candidates responsibility to read and understand the contents of this

handbook before applying for the examination.
This handbook contains current information about the
Certified Professional in Healthcare Quality (CPHQ)

Affiliation

certification examination developed by the Healthcare

HQCC, previously known as the Healthcare Quality

Quality Certification Commission (HQCC). It is essential

Certification Board (HQCB), is the certifying arm of the not-

that you keep it readily available for reference until you are

for-profit National Association for Healthcare Quality (NAHQ),

notified of your performance on the examination. All previous

which was formed in 1976 to advance the profession of

versions of this handbook are null and void.

healthcare quality through the development of a certification

For address changes, requests for a current candidate

handbook, and information about the development and
administration of the CPHQ examination, certification
program, and recertification, direct correspondence to
Certification/Recertification
HQCC Headquarters
8735 W. Higgins Road
Suite 300
Chicago, IL 60631
For general inquiries and questions about the exam or
recertification, contact HQCC at
800.966.9392
Fax 847.375.6320
E-mail: info@cphq.org
www.cphq.org

program. HQCC establishes policies, procedures, and

standards for certification and recertification in the field of
healthcare quality. The granting of CPHQ status by HQCC
recognizes professional and academic achievement through
the individuals participation in this voluntary certification
program.

Accreditation
The CPHQ certification program is fully accredited by the
National Commission for Certifying Agencies (NCCA), the
accrediting arm of the Institute for Credentialing Excellence
(ICE), Washington, DC.

Statement of
Nondiscrimination

Candidates can register for the examination online at

The certification examination is offered to all eligible

www.cphq.org.

candidates, regardless of age, gender, race, religion, national

origin, marital status, or disability. Neither NAHQ nor Applied
Measurement Professionals, Inc. (AMP), the examination
service provider, discriminates on the basis of age, gender,
race, religion, national origin, marital status, or disability.

PROGRAM OVERVIEW
Introduction to the CPHQ
Program

Questions related to the examination should be referred to

The purpose of certification in the healthcare quality field is

Olathe, KS 66061-7543, USA

to promote excellence and professionalism. The program

913.895.4600

certifies individuals who demonstrate their knowledge and

Fax: 913.895.4650

expertise in this field by passing a written examination. The

E-mail: info@goAMP.com

CPHQ designation provides the healthcare employer and the

www.goAMP.com

public with the assurance that certified individuals possess

the necessary skills, knowledge, and experience in healthcare
quality to perform competently.
The high standards of the certification program are ensured
by the close working relationships among NAHQ, HQCC,
healthcare quality professionals, and testing experts. HQCC
adheres to NCCA standards in the development and
implementation of its certification program.
The certification program is not designed to determine
who is qualified or who shall engage in healthcare
quality activities. The goal is to promote excellence and
professionalism by documenting individual performance
as measured against a predetermined level of knowledge
about quality. A cooperative effort by HQCC, AMP, and
practicing healthcare quality professionals has resulted in the
definition of tasks significant to the practice of quality. These

AMP/CPHQ Exam Services

18000 W. 105th Street

Objectives of Certification
The objectives of the certification program for quality
professionals are to
1. promote professional standards and improve the practice
of quality
2. give special recognition to those professionals who
demonstrate an acquired body of knowledge and
expertise in the field through successful completion of
the examination process
3. identify acceptable knowledge of the principles and
practice of healthcare quality for employers, the public,
and members of allied professions
4. foster continuing competence and maintain the
professional standard in healthcare quality through the
recertification program.

competencies are included in the certification examination.

The examination materials are developed by practicing
healthcare quality professionals and HQCC.

Examination Services
NAHQ contracts with AMP to provide examination services.
AMP carefully adheres to industry standards for development
of practice-related, criterion-referenced examinations to
assess competency and is responsible for administering the
certification exam and scoring and reporting examination
results.

Definition of the Quality

Professional
The practice of quality occurs in all healthcare settings,
is performed by professionals with diverse clinical and
nonclinical educational and experience backgrounds,
and involves the knowledge, skills, and abilities needed
to perform the tasks significant to practice in the CPHQ
examination content outline. (Refer to the Examination
Content Outline on page 19.)

A Certified Professional in
Healthcare Quality (CPHQ) is
an individual who has passed the
accreditation examination, demonstrating
competent knowledge, skill, and
understanding of program development
and management, quality improvement
concepts, coordination of survey processes,
communication and education techniques,
and departmental management.

Recertification
Following successful completion of the certification
examination, the CPHQ is required to maintain certification
by fulfilling continuing education (CE) requirements, which
are reviewed and established annually by HQCC. The
current requirements include obtaining and maintaining
documentation of 30 CE hours over the 2-year recertification
cyclebeginning January 1 of the year following the date
you passed the examand payment of a recertification
fee. All CE must relate to areas covered in the most current
examination content outline. Current employment in the
quality field is not required to maintain active CPHQ status.
The process for obtaining recertification is described on the

HQCCs goal is to produce examinations that test generic

concepts that can be applied to any healthcare setting.

website at www.cphq.org.

Candidates who pass the CPHQ examination must also

Eligibility Requirements

understand how all of these important elements of quality

All candidates have complete access to the examination

and case/care/disease/utilization/risk management, as well as

data and general management skills, integrate to produce an
effective and efficient system to monitor and improve care.

process. Those who aspire to excel and demonstrate their

competency in the field of healthcare quality have a chance
to do so and achieve certification.

Certification

After years of extensive experience in testing research

To become certified, each quality professional must pass

diverse backgrounds of exceptional candidates who have

the CPHQ examination. The examination is available

been successful on the examination and as CPHQs, the

in computer-based format at assessment centers in the

commission is confident that the carefully crafted CPHQ

United States and multiple international locations. Certified

examination will differentiate between candidates who are

professionals are entitled to use the designation CPHQ

able to demonstrate competence and those who are not. It

after their names. Certification in quality is effective on the

is with this confidence that HQCC celebrates the elimination

date you pass the examination. The credential is valid from

of barriers such as minimum education and experience

the time you receive your certificate through a 2-year period,

requirements that are not objectively linked to success on

which begins on January 1 of the year following the date

the examination and effectiveness as a healthcare quality

you pass the examination. Candidates who do not achieve a

professional.

passing score or whose cycle of eligibility has expired must

submit a new application.

and development, and after observing the extraordinarily

Candidates must take time to assess and judge their own

readiness to apply to take the CPHQ examination, particularly

Each successful candidate will receive a frameable certificate,

if they have not worked in the field for at least 2 years. A

identification card, CPHQ pin, and recertification information

careful review of all available information about the tasks

approximately 68 weeks after completing the examination.

covered in the CPHQ examination content outline, sample

examination questions, reference list, and any other available
data is essential before making the decision to apply for the
examination.

The examination committee develops and writes the

analysis. Recall questions test the candidates knowledge of

examination to test the knowledge, skills, and abilities of

specific facts and concepts. Application questions require

effective quality professionals who have been performing a

the candidate to interpret or apply information to a situation.

majority of the tasks on the examination outline for at least

Analysis questions test the candidates ability to evaluate,

2 years. The examination does not test at the entry level and

problem solve, or integrate a variety of information and

is not appropriate for entry-level candidates. If the candidate

judgment into a meaningful whole.

is new to healthcare quality, has worked in the field less than

2 years, or his or her experience as a quality manager was
not specifically related to healthcare, HQCC cautions that
the candidate may not be ready to attempt the examination.
Refer to the content outline later in this handbook for
detailed content information and other tools to assess
readiness.

About the Examination

The CPHQ examination is the only fully accredited,
standardized measurement of the knowledge, skills,
and abilities expected of competent healthcare quality
professionals. The examination is available in a computerized
format on a daily basis at AMP assessment centers.
The certification examination is an objective, multiple-choice
examination consisting of 140 questions. Of these questions,
125 are used in computing the score, as discussed later in
this handbook. The following percentage guidelines are
used in selecting the three types of questions that appear
on each examination: 26% recall, 57% application, and 17%

Pretest Questions on the Examination

In addition to the 125 scored questions, CPHQ examinations
also include an additional 15 pretest questions. You will be
asked to answer these questions; however, they will not be
included in the scored examination result. Pretest questions
will be disbursed within the examination, and you will not be
able to determine which of the questions are being pretested
and which will be included in your score. This is necessary to
ensure that candidates answer pretest questions in the same
manner as they do scored questions. This allows the question
to be validated as accurate and appropriate before it is
included as a measure of candidate competency.
The examination content is based upon a practice analysis
conducted every 3 years to ensure the content is current,
practice-related, and representative of the responsibilities of
healthcare quality professionals. Participants in the practice
analysis survey must have completed a minimum of 1 year
working in healthcare quality, case/care/disease/utilization/
risk management for their responses to be included in the
research.

THE CPHQ EXAMINATION

Examination Administration

Holidays

Examinations are delivered by computer at more than 170

Examinations will not be offered on the following U.S.

AMP assessment centers located throughout the United

holidays:

States. The examination is administered by appointment

New Years Day

only Monday through Friday at 9 am and 1:30 pm. Evening

Martin Luther King Day

and Saturday appointments may be scheduled based on

Presidents Day

availability. Available dates will be indicated when scheduling

Good Friday

your examination. Candidates are scheduled on a first-come,

Memorial Day

first-served basis.

Independence Day
Labor Day

International Examination
Services
For information regarding the availability of international
computerized assessment centers please visit the AMP
website at www.goAMP.com. If you are an international
candidate you will need to submit a completed application

Columbus Day
Veterans Day
Thanksgiving Day (and the following Friday)
Christmas Eve
Christmas Day
New Years Eve

international examination candidates. All examinations

Special Arrangements for

Candidates with Disabilities

will be given in computerized format only. International

AMP complies with the Americans with Disabilities Act

candidates will not receive instant score reports. Results will

and strives to ensure that no individual with a disability

be sent within 510 business days after completion of the

as defined by the ADA as a person who has a physical or

examination to the candidates address on record.

mental impairment that substantially limits one or more

form and the application fee. All other rules and regulations
regarding the computerized examination apply to

major life activities, a person who has a history or record

Assessment Center Locations

of such an impairment, or a person who is perceived by

AMP assessment centers have been selected as CPHQ

opportunity to take the examination solely by reason of that

testing sites to provide accessibility to the most candidates

disability. AMP will provide reasonable accommodations for

in all states and major metropolitan areas. A current listing

candidates with disabilities. Candidates requesting special

of AMP assessment centers, including addresses and

accommodations must call AMP at 888.519.9901 to schedule

driving directions, may be viewed at www.cphq.org. Specific

their examination.

address information will be provided when you schedule an

examination appointment.

others as having such an impairmentis deprived of the

1. Wheelchair access is available at all established

assessment centers. Candidates must advise AMP at the
time of scheduling that wheelchair access is necessary.

2. Candidates with visual, sensory, physical, or learning

2. Check: Complete the online application and mail your

disabilities that would prevent them from taking the

check for appropriate fees to HQCC/NAHQ. Please note

examination under standard conditions may request

that there is an additional $25 fee for payment by check.

special accommodations and arrangements and will be

reviewed by AMP.

HQCC will process your check and within approximately

2 weeks you will receive a confirmation notice including

Verification of the disability and a statement of the specific

a website address and toll-free telephone number to

type of assistance needed must be made in writing to AMP

contact AMP to schedule an examination appointment.

at least 45 calendar days prior to your desired examination

If eligibility cannot be confirmed, notification why the

date by completing the Request for Special Examination

application is incomplete will be sent. If a confirmation of

Accommodations and Documentation of Disability-Related

eligibility notice is not received within 4 weeks, contact

Needs forms. AMP will review the submitted forms and will

AMP at 888.519.9901.

contact you regarding the decision for accommodations.

Telecommunication Devices for the

Deaf
AMP is equipped with Telecommunication Devices for the
Deaf (TDD) to assist deaf and hearing-impaired candidates.
TDD calling is available 8:30 am5 pm (CST), MondayFriday
at 913.895.4637. This TDD phone option is for individuals
equipped with compatible TDD machinery.

Applying for and Scheduling

an Examination

When you schedule your examination appointment, be

prepared to confirm a location and preferred date and
time for testing. You will be asked to provide your unique
identification number. When you call or go online to schedule
your examination appointment, you will be notified of the
time to report to the assessment center and if an e-mail
address is provided you will be sent an e-mail confirmation
notice.
If special accommodations are being requested, complete
the Request for Special Examination Accommodations form
included in this handbook and submit it to AMP at least 45
days prior to the desired examination date.

1. Online Application and Scheduling: You may complete

the application process online by visiting www.cphq.
org and selecting CPHQ Exam. The instructions will
guide you through the application process. After the
application information and credit card payment (VISA,
MasterCard, American Express, and Discover) have been
submitted, you will receive an e-mail in approximately
1 week from AMP with instructions on how to schedule
your exam. Upon payment, you will have 90 days to
schedule and sit for the exam.
OR

Rescheduling an Examination

contact AMP at least 2 business days prior to the

You may reschedule your appointment ONCE at no charge

by calling AMP at 888.519.9901 at least 2 business days prior
to your scheduled appointment. The following schedule
applies.

You wish to reschedule an examination but fail to

scheduled testing session.

You wish to reschedule a second time.

You appear more than 15 minutes late for an

examination.

If your examination
is scheduled on...

You must call AMP by 3 pm CT

to reschedule the examination
by the previous...

Monday

Wednesday

Tuesday

Thursday

Wednesday

Friday

Thursday

Monday

No Refunds

Friday

Tuesday

Fees are nonrefundable. Declined credit cards will be subject

You fail to report for an examination

appointment.

A new, complete application and examination fee are

required to reapply for examination.

to a $25 handling fee. A certified check or money order for

Canceling an Examination

the amount due, including the handling fee, must be sent to

HQCC/NAHQ to cover declined credit card transactions.

You may cancel your appointment by contacting AMP at

888.519.9901 at least 3 business days prior to your scheduled
appointment. The following schedule applies.

Inclement Weather, Power

Failure, or Emergency

If your examination
is scheduled on...

You must call AMP by 3 pm CT

to reschedule the examination
by the previous...

Monday

Tuesday

Tuesday

Wednesday

not be rescheduled if the assessment center personnel are

Wednesday

Thursday

able to open the assessment center.

Thursday

Friday

Friday

Monday

All fees are nonrefundable.

In the event of inclement weather or unforeseen emergencies

on the day of an examination, AMP will determine whether
circumstances warrant the cancellation, and subsequent
rescheduling, of an examination. The examination will usually

Visit AMPs website at www.goAMP.com prior to the

examination to determine if AMP has been advised that any
assessment centers are closed. Every attempt is made to
administer the examination as scheduled; however, should an

Missed Appointments and

Cancellations
You will forfeit your examination registration and all fees paid
to take the examination under the following circumstances:

10

examination be canceled at an assessment center, all scheduled

candidates will receive notification following the examination
regarding rescheduling or reapplication procedures.
If power to an assessment center is temporarily interrupted
during an administration, your examination will be restarted.

You cancel your examination after confirmation of

The responses provided up to the point of interruption will be

eligibility is received.

intact, but for security reasons the questions will be scrambled.

RULES FOR COMPUTERIZED TESTING

Taking the Examination
Your examination will be given by computer at an AMP
assessment center. You do not need any computer

The following security procedures apply during the

examination:

tape recorders, personal digital assistants (PDAs),

experience or typing skills to take your examination. On

pagers, or cellular phones are allowed in the

the day of your examination appointment, report to the

testing room. Possession of a cellular phone or

assessment center no later than your scheduled testing time.

other electronic devices is strictly prohibited and

Look for signs indicating AMP assessment center check-in.

If you arrive more than 15 minutes after the scheduled
testing time, you will not be admitted.

Examinations are proprietary. No cameras, notes,

will result in dismissal from the examination.

Calculators are not necessary as all calculations

found on the examination can be performed
without the aid of a calculator. However, if

Identification

you wish to do so you are permitted to bring

a personal calculator and use it during the

To gain admission to the assessment center, you must present

examination. The only type of calculator

two forms of identification, one with a current photograph.

permitted is a simple battery-powered pocket

Both forms of identification must be valid and include your

calculator that does not have an alphanumeric

current name and signature. You will also be required to sign

keypad, and does not have the capability to print

a roster for verification of identity. You MUST bring one of the

or to store or retrieve data. You MUST present

following:

your calculator to the examination proctor for

drivers license with photograph

state identification card with photograph

Using a calculator during the examination that

passport

has NOT been inspected may result in dismissal

military identification card with photograph.

inspection PRIOR to the start of the examination.

from the examination.

The second form of identification must display your name

No guests, visitors, or family members are

allowed in the testing room or reception areas.

and signature for signature verification (e.g., credit card with

signature, social security card with signature, employment
or student ID card with signature). If your name on these

Personal Belongings

documents is different than it appears on your identification,

No personal items, valuables, or weapons should be

you must bring proof of your name change (e.g., marriage

brought to the assessment center. Only wallets and keys

license, divorce decree, or court order).

are permitted. Coats must be left outside the testing room.

You will be provided a soft locker to store your wallet and/or

Assessment Center Security

keys with you in the testing room. You will not have access to

AMP administration and security standards are designed to

note the following items will not be allowed in the testing

ensure all candidates are provided the same opportunity

room except securely locked in the soft locker:

to demonstrate their abilities. The assessment center is

continuously monitored by audio and video surveillance
equipment for security purposes.

these items until after the examination is completed. Please

watches

hats.

11

Once you have placed everything into the soft locker, you will
be asked to pull out your pockets to ensure they are empty. If

Misconduct

all personal items will not fit in the soft locker you will not be

If you engage in any of the following conduct during the

able to test. The site will not store any personal belongings.

examination you may be dismissed, your scores will not

be reported, and examination fees will not be refunded.

If any personal items are observed in the testing room

after the examination is started, the administration will be
forfeited.

Examination Restrictions

Pencils will be provided during check-in.

You will be provided with one piece of scratch

Examples of misconduct are when you

uncooperative

candidate. You must return the scratch paper to

the supervisor at the completion of testing, or

PDAs

No documents or notes of any kind may be

give or receive help or are suspected of doing so

leave the assessment center during the

administration

No questions concerning the content of

examination.

are observed with personal belongings

Eating, drinking, or smoking will not be

are observed with notes, books, or other aids

permitted in the assessment center.

attempt to take the examination for someone

else

the examination may be asked during the

attempt to record examination questions or make

notes

removed from the assessment center.

talk or participate in conversation with other

examination candidates

you will not receive your score report.

display or use electronic communications

equipment such as pagers, cellular phones, and

paper at a time to use during the examination,

unless noted on the sign-in roster for a particular

create a disturbance, are abusive, or otherwise

You may take a break whenever you wish, but

you will not be allowed additional time to make
up for time lost during breaks.

without it being noted on the roster.

Copyrighted Examination
Questions
All examination questions are the copyrighted property of
NAHQ. It is forbidden under federal copyright law to copy,
reproduce, record, distribute, or display these examination
questions by any means, in whole or in part. Doing so may
subject the candidate to severe civil and criminal penalties.

12

Practice Examination

Only one examination question is presented at a time. The

Prior to attempting the timed examination, you will be given

screen. Choices of answers to the examination questions are

the opportunity to practice taking an examination on the

identified as A, B, C, or D. You must indicate your choice by

computer. The time used for this practice examination is NOT

either typing in the letter in the response box in the lower

counted as part of the examination time or score. When you

left portion of the computer screen or clicking on the option

are comfortable with the computer testing process, you may

using the mouse. To change an answer, enter a different

quit the practice session and begin the timed examination.

option by pressing the A, B, C, or D key or by clicking on

question number appears in the lower right portion of the

the option using the mouse. You may change your answer as

Timed Examination
Following the practice examination, the actual examination

many times as you wish during the examination, within the

time limit.

will begin. Before beginning, instructions for taking the

To move to the next question, click on the forward arrow

examination are provided on-screen.

(>) in the lower right portion of the screen or select the

NEXT key. This action will move you forward through the
examination question by question. To review any question,
click the backward arrow (<) or use the left arrow key to move
backward through the examination.

The computer monitors the time spent on the examination.

You will have 3 hours to complete the examination. The
examination will terminate if testing exceeds the time
allowed. Click on the Time box in the lower right portion
of the screen or select the TIME key to monitor testing time.
A digital clock indicates the time remaining to complete the
examination. The time feature may be turned off during the
examination.

An examination question may be left unanswered for

return later in the examination session. Questions may also
be bookmarked for later review by using the mouse and
clicking in the blank square to the right of the Time box.
Click on the hand icon or select the NEXT key to advance
to the next unanswered or bookmarked question on the
examination. To identify all unanswered and bookmarked
questions, repeatedly click on the hand icon or press the
NEXT key. When the examination is completed, the number
of examination questions answered is reported. If not all
questions have been answered and there is time remaining,
return to the examination and answer those questions. Be sure
to provide an answer for each examination question before
ending the examination. There is no penalty for guessing.

Candidate Comments
During the examination, comments may be provided for any
question by clicking on the button displaying an exclamation
point (!) to the left of the Time box. This opens a dialogue
box where comments may be entered. Comments will be
reviewed, but individual responses will not be provided.

13

Following the Examination

or fail, followed by a raw score indicating the number

After you finish the examination, you are asked to complete

provided in the form of raw scores by each of the four major

a short evaluation of your testing experience. Then, you are

content categories. This information is provided as feedback

instructed to report to the examination proctor to receive

to help you understand your performance within the major

your score report. Scores are reported in printed form

content categories. Your pass or fail status is determined

only, in person or by U.S. mail. To ensure confidentiality,

by your overall raw score for the entire examination. Even

no candidate examination scores will be reported over the

though the examination consists of 140 questions, your score

telephone, by electronic mail, or by facsimile. Neither HQCC

is based on 125 scored questions. Fifteen of the questions on

nor the testing agency will release a copy of individual

the examination are pretest questions and are not included

score reports to employers, schools, or other individuals or

in the final score.

of questions you answered correctly. Additional detail is

organizations without your written authorization.

Failing candidates may reapply for subsequent examinations.
The score report you receive as you leave the assessment

more than three times in 1 year. If a candidate fails to pass

of the examination. This is an unofficial score report. You may

the exam after three attempts in 1 year, he or she must wait 1

not use the CPHQ credential until you receive your official

full calendar year to sit for the exam again.

documentation. The score report will reflect either pass

14

Candidates may test one time per 90-day period and no

center will include your photograph, taken prior to the start

GENERAL INFORMATION
Fees
Fees for the CPHQ examination are shown in the table that
follows.

Scores Canceled by HQCC or

AMP
HQCC and AMP are responsible for the integrity of the
scores they report. On occasion, occurrences such as

CPHQ Examination Fees

Nonmember Fee
(in U.S. dollars)

computer malfunction or misconduct by a candidate may

NAHQ Member Fee

(in U.S. dollars)

All Examinations:

cause a score to be suspect. HQCC and AMP are committed

to rectifying such discrepancies as expeditiously as possible.
Examination results may be voided if, upon investigation,

Online by credit
card

$440

$370

violation of regulations is discovered.

If payment
is mailed or
phoned in

$465*

$395*

Disciplinary Policy

* While candidates must apply for the certification online,

payment can be mailed in with the completed printed
application. If payment is received this way or in any other form
than online, an additional $25 fee must be included.

HQCC shall undertake sanctions against applicants,

candidates, or individuals already awarded the CPHQ
designation only in relation to failure to meet requirements for
initial certification or recertification. The CPHQ certification
program is a voluntary process, not required by law for
employment in the field. Monitoring and evaluating actual job
performance is beyond the scope of HQCC and NAHQ.

If you wish to join NAHQ, contact NAHQ at 800.966.9392 or

visit www.nahq.org.

Applications may be refused, candidates may be barred from

future examinations, or candidates or individuals already

Exam fees may be paid by credit card, personal check, or

certified may be sanctioned, including revocation of the

money order for the total amount, payable to HQCC/NAHQ.

CPHQ designation, for the following reasons:

Checks drawn on non-U.S. banks must state Payable in U.S.

Dollars. Please write the name of the candidate taking the

or on recertification documents or during the

exam on the face of your check. An additional $25 charge will

be added for any returned checks or rejected credit cards to
cover additional handling fees and service charges imposed

random audit procedure

giving or receiving information to or from another

candidate during the examination

by the bank or credit card company. Your canceled check

or credit card receipt serves to document payment for the

attesting to false information on the application

removing or attempting to remove examination

materials or information from the testing site

examination.

unauthorized possession or distribution of any

official testing or examination materials

representing oneself falsely as a designated CPHQ.

15

Pass or Fail Score

Determination
Neither HQCC nor AMP is able to release or discuss
individual questions with candidates following the
examination. To do so would require elimination of that
question from the item bank of pretested questions and
deplete the number of pretested questions required to
develop future versions of the examination.
The methodology used to set the minimum passing score
is the Angoff method, applied during the performance of
a Passing Point Study by a panel of experts in the field.
The experts evaluated each question on the examination
to determine how many correct answers are necessary to
demonstrate the knowledge and skills required to pass this
examination portion. Your ability to pass the examination
depends on the knowledge and skill you display, not on the
performance of other candidates.
Passing scores may vary slightly for each version of the
examination. To ensure fairness to all candidates, a process
of statistical equating is used. This involves selecting an
appropriate mix of individual questions for each version
of the examination that meet the content distribution
requirements of the examination content blueprint. Because
each question has been pretested, a difficulty level can be
assigned. The process then considers the difficulty level of
each question selected for each version of the examination,

If you pass the CPHQ examination, you are entitled to

use the designation Certified Professional in Healthcare
Quality and registered acronym CPHQ with your name
on letterheads, business cards, and all forms of address.
Certification is for individuals only. The CPHQ designation
may not be used to imply that an organization, association, or
private firm is certified.
For U.S. candidates, HQCC will mail a congratulatory letter
and information packet to each new CPHQ, which includes
an identification card, certificate, and CPHQ pin. For
international candidates, HQCC will mail a congratulatory
letter and information packet to the new CPHQ. Your name,
as stated on the application, will appear on the certificate.
HQCC will attempt to mail the materials to the candidates
address but cannot guarantee it will reach the international
CPHQ. A second attempt will be made to a second address,
such as a work address. The third and final attempt will be
made through an overnight vendor. Costs of reshipment
will be the responsibility of the international CPHQ. You
should expect to receive this packet approximately 1 month
following the end of the month during which you took and
passed the examination.
HQCC reserves the right to recognize publicly any candidate
who has successfully completed a CPHQ certification
examination, thereby earning the certification credential.

attempting to match the difficulty level of each version as

Replacement certificates and PDF certificates can be purchased

closely as possible. To ensure fairness, slight variations in

by sending a written request and the required $25 fee to

difficulty level are addressed by adjusting the passing score

HQCC/NAHQ. Replacement or extra CPHQ pins are available

up or down, depending on the overall difficulty level statistics

for $25. The reorder form is available at www.cphq.org.

for the group of scored questions that appear on a particular

version of the examination.

16

If You Pass the Examination

Continuing Education Credit

Some organizations accept successful completion of a
certification examination for continuing education (CE) credit.
Check with your licensure or registration board or association
for acceptance and CE credits allowed.
Refer to the Recertification section of this handbook (page
6) for details about CE requirements to maintain CPHQ status
after passing the examination.

appeals may be considered for alleged inappropriate

examination administration procedures or environmental
testing conditions severe enough to cause a major disruption
of the examination process and which could have been
avoided.
Appeals may be submitted by e-mail to info@cphq.org or
in writing by mail to the attention of the HQCC chair at the
address below:
HQCC Headquarters

Verification of CPHQ Status

Information on the current certification status of an individual
will be provided to the public upon request. Employers
who request verification of CPHQ status must provide the
individuals name and CPHQ number to ensure correct
identification in the CPHQ database. Annually, a listing of
successful candidates will be published on the CPHQ website
at www.cphq.org.

If You Fail the Examination

If you do not pass the certification examination, you may
reapply for subsequent examinations. You may test one time
per 90-day period and the test can only be taken three times
in 1 year. Repeat candidates must submit a new application
and full examination fee. Names of candidates who do not
pass the examination are confidential and are not revealed
under any circumstances, except by legal compulsory
process.

Appeals
Because the performance of each question on the
examination that is included in the final score has been
pretested, there are no appeal procedures to challenge
individual examination questions, answers, or a failing score.

8735 W. Higgins Road

Suite 300
Chicago, IL 60631
Equivalency eligibility appeals must be received within
30 days of the initial HQCC action. Appeals for alleged
inappropriate administration procedures or severe adverse
environmental testing conditions must be received within 60
days of the release of examination results.
The HQCC Chair will respond within 30 days of receipt of the
appeal. If this decision is adverse, the candidate may file a
second-level appeal within 30 days. A three-member panel of
HQCC will review the chairs decision and respond with a final
decision within 45 days of receipt.

Duplicate Score Report

You may purchase additional copies of your score report
at a cost of $25 per copy payable to AMP. Requests must
be submitted to AMP, in writing, within 90 days after
the examination. The request must include your name,
CPHQ number, mailing address, date of examination, and
authorization signature. Use the form in the back of this
handbook to request a duplicate score report. Duplicate
score reports will be mailed approximately 5 business days
after receipt of the request.

Actions by the commission affecting eligibility of a candidate

to take the examination may be appealed. Additionally,

17

Verification of Scores

5. Facilitation at a Glance: Your Pocket Guide to Facilitation.

Bens, Ingrid. (2008).

In computer-based testing, the computer accepts responses

from a keyboard or mouse in digitized form. Computerbased testing eliminates problems that may have previously
arisen with scanning paper-and-pencil answer sheets,
because all responses are recorded by candidates during
their examinations. However, verification of examination
scores from electronic responses can be requested. For
more information about the process and fee for this service,
contact HQCC at 800.966.9392 on info@cphq.org within 90
days after the examination.

Preparation for the CPHQ

Certification Examination
HQCC neither sponsors, endorses, nor financially benefits
from any review courses or published materials for the CPHQ
certification examination. Examination questions are written
from a wide variety of publications and resources in the field.
Some suggested preparation for the examination might
include but should not be limited to the following resources:
1. Q-Solutions: Essential Resources for the Healthcare
Quality Professional, 3rd ed. (NAHQ) www.nahq.org
2. The CPHQ Self-Assessment Exam. This self-assessment
can help identify areas of strength or improvement for
the CPHQ examination. www.cphq.org
3. CPHQ Virtual Review Course. The presentation was
recorded at a live CPHQ Review Course and contains
four modules that follow the exam matrix, including two
to three practice questions with answers to help you
prepare. www.nahq.org
4. The Healthcare Quality Handbook: A Professional
Resource and Study Guide. Brown, Janet A. and Mellott,
Susan (2015). www.nahq.org.

18

6. Preventing Medication Errors. Institute of Medicine.

(2007).
7. The Six Sigma Way Team Fieldbook. Pande, Peter,
Neuman, Robert, & Cavanagh, Roland. 2002.
8. Understanding Patient Safety. Wachter, Robert, 2008.
9. Improving Health Care Using Toyota Lean Production
Methods. Chalice, Robert. 2007.
10. The Quality Toolbox. Tague, Nancy, 2005.
11. Lean Six Sigma Pocket Toolbook. George, Michael,
Rowlans, David, Price, Mark & Maxey, John. 2005.
12. The Memory Jogger 2, 2nd ed. Brassard, Michael.
www.goalqpc.com
13. A Dash Through the Data! Using Data for Improvement:
An Educational DVD on the Basics of Using Data for QI.
Murray, Sandra K. www.nahq.org
14. Patient Safety-Achieving a New Standard for Care:
Quality Chasm Series
15. The Team Handbook, 3rd ed. 2003
16. The Lean Enterprises Memory Jogger. Richard L.
Macinnes
17. Agency for Healthcare Research and Quality: www.ahrq.
gov
18. Institute for Healthcare Improvement: www.ihi.org/
Pages/default.aspx
19. Institute for Safe Medication Practices: www.ismp.org

CPHQ EXAMINATION CONTENT OUTLINE

The content validity of the CPHQ examination is based
on a practice analysis which surveyed healthcare quality
professionals on the tasks they perform. Each question on the
examination is linked directly to one of the tasks listed below.
In other words, each question is designed to test whether the
candidate possesses the knowledge necessary to perform the
task or has the ability to apply it to a job situation.
Each of the tasks below was rated as significant to practice
by healthcare quality professionals who responded to the
survey. One rule used by the exam committee requires that a
task be significant to practice in the major types and sizes of
healthcare facilities, including those employed in managed
care. Thus the examination content is valid for this segment
of healthcare quality professionals and those employed in
hospital, clinic, home care, behavioral and mental health, or
other care settings.
The following is a list of tasks that forms the content outline
of the CPHQ examination and to which the examination
questions are linked.

CPHQ Examination
Specifications*
I.

Management and Leadership (21 items)

A. Strategic
1. Facilitate development of leadership values and
commitment to quality.
2. Facilitate program and project development
and evaluation (e.g., enterprise risk
management, patient safety, infection
prevention and control, or new service lines).
3. Facilitate assessment, development, and design
of the organizations quality culture.

4. Facilitate or participate in organization-wide

strategic planning.
5. Link performance/quality improvement activities
with strategic goals.
6. Identify customer and supplier relationships
(internal and external).
7. Facilitate or participate in developing an
organizational vision and mission statement.
8. Identify performance measures and quality
indicators (e.g., balanced scorecards or
dashboards).
9. Participate in the integration of environmental
safety programs within the organization (e.g., air
quality, infection control practices, building, and
hazardous waste).
10. Determine applicability of performance
improvement models (e.g., PDCA, Six Sigma, or
Lean).
11. Facilitate evaluation and selection of
appropriate accreditation or recognition
program(s) (e.g., The Joint Commission (TJC),
Magnet, Baldrige, Det Norske Veritas (DNV),
American Osteopathic Association (AOA),
or Healthcare Facility Accreditation Program
(HFAP)).
12. Demonstrate financial benefits of a quality
program.
13. Lead and facilitate change within the
organization.
14. Integrate the results of the performance/quality
improvement process into strategic planning for
the organization.

19

B. Operational
1. Facilitate establishment of a performance/
quality improvement oversight group (e.g.,
Quality Council, Steering Council, QM
Committee, or Patient Safety Committee).
2. Identify champions (e.g., stakeholders, process
owners, quality, or patient safety).
3. Communicate organizational values and
commitment to staff.
4. Interact with external quality consultants (i.e.,
subject matter experts).
5. Coordinate survey processes (i.e., accreditation,
licensure, or equivalent).

II. Information Management (31 items)

A. Design and Data Collection

2. Use basic statistical techniques to present data

(e.g., mean or standard deviation).
3. Use or coordinate the use of statistical process
control components (e.g., common and special
cause variation, random variation, or trend
analysis).
4. Interpret data to support decision making (e.g.,
benchmarking or outcome data).
C. Communication
1. Interact with staff regarding quality issues
(e.g., patient issues, service delivery, or human
resources).
2. Compile and write performance/quality
improvement reports.

2. Organize information for committee meetings

(e.g., agendas, reports, or minutes).

3. Coordinate and promote the dissemination of

performance/quality improvement information
within the organization.

4. Assess customer needs and expectations (e.g.,

surveys, focus groups, or teams) to ensure the
voice of the customer is heard.
5. Perform or coordinate data inventory listing
activities (i.e., availability of data from various
sources).
6. Perform or coordinate data definition activities.
7. Perform or coordinate data collection
methodology (e.g., qualitative or quantitative).

20

1. Facilitate the use of process analysis tools to

display data (e.g., fishbone, Pareto chart, run
chart, scattergram, or control chart).

1. Maintain confidentiality of performance/quality

improvement records and reports.

3. Use epidemiological principles in data

collection and analysis.

B. Measurement and Analysis

4. Participate in public reporting activities (e.g.,

organizational transparency, website content, or
ensuring accuracy).
5. Facilitate communication with accrediting and
regulatory bodies.

5. Participate in the process of organizational

reviews or audits for

III. Performance/Quality Measurement and Improvement

(45 items)

a. safe medicine practices (e.g., medication

usage evaluation)

A. Planning
1. Facilitate establishment of priorities for
performance/quality improvement activities.

b. medical records
c. mortality and morbidity review

2. Facilitate development of performance/quality

improvement action plans and projects.

d. infection prevention and control processes

3. Facilitate program development, evaluation,

planning, projects, and activities.

e. peer review

4. Facilitate development or selection of process

and outcome measures.

f.

5. Facilitate evaluation or selection of evidencebased practice guidelines (e.g., for standing

orders or as guidelines for physician ordering
practice).

g. service quality (e.g., satisfaction results,

complaints, or employees).
6. Facilitate or participate in the process of
departmental reviews (e.g., pathology,
radiology, pharmacy, or nursing).

6. Facilitate or participate in the development of

clinical and critical pathways or guidelines.

7. Perform or coordinate risk management (e.g.,

risk identification, analysis, evaluation, and
prevention).

7. Aid in evaluating the readiness to apply for

external quality awards.
8. Aid in evaluating survey readiness for
accrediting and regulatory bodies.

B. Implementation and Evaluation

1. Participate on performance/quality
improvement teams (i.e., as a coordinator, team
member, leader, or facilitator).
2. Evaluate team performance.
3. Facilitate or participate in the credentialing and
privileging process (e.g., Focused Professional
Practitioner Evaluation (FPPE) or Ongoing
Professional Practitioner Evaluation (OPPE)).

patient advocacy (e.g., patient rights or

ethics)

C. Education and Training

1. Design organizational performance/quality
improvement training (e.g., quality or patient
safety).
2. Provide training on performance/quality
improvement, program development, or
evaluation concepts.
3. Evaluate effectiveness of performance/quality
improvement training.
4. Provide survey preparation training (e.g.,
accreditation, licensure, or equivalent).

4. Coordinate or participate in quality

improvement projects.

21

IV. Patient Safety (28 items)

A. Strategic
1. Facilitate assessment and development of the
organizations patient safety culture.
2. Identify applicability of external patient safety
initiatives (e.g., regulatory, accreditation, or
WHO).
3. Facilitate the ongoing development and
enhancement of a patient safety program.

B. Operational
1. Contribute to development and revision of a
written plan for a patient safety program.
2. Determine how technology can enhance the
patient safety program (e.g., CPOE, BCMA/
barcoding, EMR, abduction/elopement security
systems, or human factors engineering).
3. Integrate patient safety initiatives into
organizational activities.

4. Link patient safety activities with strategic goals.

4. Participate in the process of patient safety goals

review.

5. Integrate patient safety concepts within the

organization.

5. Perform or coordinate risk management:

a. incident report review
b. sentinel or unexpected event review
c. root cause analysis
d. failure mode and effects analysis.
* Approximately 26% of the items will require recall on
the part of the candidate, 57% will require application of
knowledge, and 17% will require analysis. Each test form
will include 15 unscored pretest items in addition to the 125
scored items.

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REQUEST FOR SPECIAL

EXAMINATION ACCOMMODATIONS
If you have a disability covered by the Americans with Disabilities Act, please complete this form and the Documentation
of Disability-Related Needs on the reverse side so your examination accommodations can be processed efficiently. The
information you provide and any documentation regarding your disability and your need for examination accommodations will
be treated with strict confidentiality.

Candidate Information
Social SecurityNumber___________________ _________________
Name (Last, First, Middle Initial, Former Name)________________________________________________________________________
Mailing Address ___________________________________________________________________________________________________
City__________________________________________________________________State___________ Zip/Postal Code________________
Daytime Telephone Number________________________________________________________________________________________

Special Accommodations
I request special accommodations for the________________________________________ examination.
Please provide (check all that apply):
________ Reader

________ Reduced distraction environment

________ Extended examination time (time and a half)

________ Other special accommodations are needed (please

specify below)

Comments:_______________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________

PLEASE READ AND SIGN: I give my permission for my diagnosing professional to discuss with AMP staff my records and
history as they relate to the requested accommodation.
Signature______________________________________________________________________________ Date_______________________
Return this form with your examination application and fee to:
AMP/CPHQ Exam Services, 18000 W. 105th Street, Olathe, KS 66061-7543.
If you have questions, call the Examination Services Department at 913.895.4600.

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DOCUMENTATION OF
DISABILITY-RELATED NEEDS
Please have this section completed by an appropriate professional (education professional, physician, psychologist, psychiatrist)
to ensure that AMP is able to provide the required examination accommodations.

Professional Documentation
I have known______________________________________________ since _________ / __________ / _____________ in my capacity as a
Candidate Name

Date

Professional Title__________________________________________________________________________________________________

The candidate discussed with me the nature of the examination to be administered. It is my opinion that, because of this
candidates disability described below, he or she should be accommodated by providing the special arrangements listed on the
reverse side.
Description of Disability:____________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________

Signed________________________________________________________________ Title_______________________________________
Printed Name_____________________________________________________________________________________________________
Address__________________________________________________________________________________________________________
TelephoneNumber________________________________________________________________________________________________
Date________________________________ License Number (if applicable)_________________________________________________
Return this form with your examination application and fee to:
AMP/CPHQ Exam Services, 18000 W. 105th Street, Olathe, KS 66061-7543.
If you have questions, call the Examination Services Department at 913.895.4600.

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REQUEST FOR DUPLICATE CPHQ

EXAMINATION SCORE REPORT
Directions: You may use this form to ask AMP, the testing agency, to send you a duplicate copy of your score report. This
request must be postmarked no later than 90 days after the examination administration. Proper fees and information must be
included with the request. Please print or type all information in the form below. Be sure to provide all information and include
the correct fee, or the request will be returned.
Fees: $25 U.S. Dollars per copy. Please enclose a check or money order payable in U.S. Dollars to AMP. Do not send cash. Write
your test identification number on the face of your payment.
Mail to: AMP/CPHQ Exam Services

18000 W. 105th Street

Olathe, KS 66061-7543, USA

Amount enclosed: $___________________

Examination Date: ____________________

Print your current name and address:

Name____________________________________________________________________ Candidate ID____________________________
Street_____________________________________________________________ City___________________________________________
State/Prov.___________ Zip/Postal Code_________________________ Country______________________________________________
Daytime Telephone (_______)___________________________________ Fax (_______)_________________________________________
E-Mail____________________________________________________________________________________________________________

If the above information was different at the time you were tested, please write the original information below:
Name ___________________________________________________ Candidate ID or Social Security Number_____________________
Street_____________________________________________________________ City___________________________________________
State/Prov.___________ Zip/Postal Code_________________________ Country______________________________________________
Daytime Telephone (_______)___________________________________ Fax (_______)_________________________________________
E-Mail____________________________________________________________________________________________________________
Examination Date________________________________ Test Site__________________________________________________________

I hereby request AMP to send a duplicate copy of my score report to the first address shown above.
Candidates Signature_________________________________________________________________ Date________________________

25

REQUEST TO CHANGE MAILING

OR E-MAIL ADDRESS
All address and e-mail changes must be submitted in writing, either by mail or fax, including an authorization signature and
candidate ID number.
You may use this form to request that HQCC enter a change of address, including e-mail address, into our database once you
have registered for the examination. To protect your confidential record and ensure that no unauthorized person is able to alter
your record, we require that all address changes be submitted in writing and include your authorizing signature.
HQCC will forward your address change to the testing agency AMP. If you have questions, please contact HQCC at
800.966.9392 or info@cphq.org.
Mail or fax your request to:
HQCC Headquarters
8735 W. Higgins Road, Suite 300
Chicago, IL 60631
Fax: 847.375.6320
Print your NEW name and address (home address is recommended):
Name ____________________________________________________________________ Candidate ID____________________________
Street_____________________________________________________________ City___________________________________________
State/Prov.___________ Zip/Postal Code_________________________ Country______________________________________________
Work Telephone (_______)________________________________ Home Telephone (_______)_________________________________
E-Mail____________________________________________________________________________________________________________
Print your OLD information as it appeared on your application form:
Name ______________________________________________________________________________________ (if different from above)
Street_____________________________________________________________ City___________________________________________
State/Prov.___________ Zip/Postal Code_________________________ Country______________________________________________
Work Telephone (_______)________________________________ Home Telephone (_______)_________________________________
E-Mail____________________________________________________________________________________________________________
Examination Date________________________________ Test Site __________________________________________________________
I hereby authorize HQCC and AMP to change my address in the examination database as shown above.
Candidates Signature_________________________________________________________________ Date________________________
Healthcare Quality Certification Commission of the National Association for Healthcare Quality
8735 W. Higgins Road
Suite 300
Chicago, IL 60631
800.966.9392
Fax 847.375.3620
www.cphq.org

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