AAMSN Member Moderate Sedation Re-Certification

AAMSN Member Moderate Sedation Re-Certification
Sedation Re-certification is every 2 years. AAMSN Membership is yearly.

CEs awarded for your nursing license is acceptable.

Membership dues $65.00 Annually
Name:
AAMSN Member ID#:
Sedation Certification Date:
Address:
City:
State:
Zip:
Phone (Home/Cell):
Phone (Work):
Email:
example@example.com
Nursing License #:
If other i.e. MD, Dentist please list
Advanced Nurse License #:
PA License #:
State Licensed:
License Expiration Date:

MonthDayYear
Date
Current ACLS or PALS required for recertification
ACLS Expiration Date:

MonthDayYear
Date
PALS Expiration Date:

MonthDayYear
Date
Place of Employment:
Where do you give sedation? i.e. ED, Endoscopy, Peds etc:

List your CE credits: (30 CEs required for re-certification)

Total number of CE credits
Upload a copy of your nursing license

Browse Files
Required but you can email lena@aamsn.org or fax 865-269-4613 Cancelof
Upload a copy of your ACLS or PALS card

Browse Files
Required but you can email lena@aamsn.org or fax 865-269-4613 Cancelof
AAMSN

322 Commerce Street

Clinton TN 37716

865-230-9995

aamsn.org

info@aamsn.org

Re-certification is every 2 years.
Stop here if you are sending a check or you have already paid online.

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AAMSN Membership Dues
This is a yearly renewal

$65.00



Late Fee AAMSN Membership Dues
If membership is expired more than 15 days

$15.00



Re-certification Fee - If your AAMSN membership is past due more than 30 days AND it is time for your Sedation Re-certification
$100.00



Total

$0.00
Please allow 14-21 days for your recertification and/or membership to be processed.
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