Menu

Social Link

Facebook
Twitter
Linked In
Instagram

Contact us at 404-760-8190 Toll free: 844-GOT-VABC (468-8222)|© 2020 The Vascular Access Certification Corporation (VACC)

Contact us at 404-760-8190 Toll free: 844-GOT-VABC (468-8222) Certificant Portal Apply Now

Home
Getting Certified
Recertification
About VACC
Industry Program
Volunteer
- Opportunities
Store

Online Application

Step 1 of 4

25%

Please make info@vacert.org a friendly email address for your email reader.
Click here for instructions.
Candidate Information
Fields marked with * are required.

Your first and last name must match the name on your government-issued identification.
Number of Years*
First Name (must match your ID)*
Middle Initial/Name
Last Name (must match your ID)*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone Number*
Email
Email*
Credentials*
AVA Member ID (You MUST enter your 8-digit AVA Member ID in order to receive the AVA discount on the exam. If you do not have your 8 digit number please contact AVA at ava@avainfo.org BEFORE submitting this application)
AVA Member ID
Discount Code
Organization/Business*
Job Title*
Organization/Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Application*
Enter your certification number*
If you don't remember your Certification Number Click Here
Dates of Previous Exams*
Require Special Accomodations*
- Yes
- No
Keep me informed about VACC business and events*
- Yes
- No
By submitting this form I agree to the terms and conditions of the VACC Privacy Policy*
- Yes
- No
Click Here to view the VACC Privacy Policy

Save and Continue Later

Highest Degree*
- Certificate
- Diploma
- Associate
- Batchelors
- Doctorate (MD, DO, PhD, DNP)
- Other
Employment Status*
- Full Time
- Part Time
- Per diem/casual
- Not currently working
Primary Job Function
- Management/Supervisory
- Education
- Patient Care
- Other
Primary Patient Population*
- Aduly
- Pediatric
- Adult and Pediatric
- Adult, Pediatric, Neonatal
- Neonatal
Current Position*
- Clinical Nurse Specialist
- Advanced Practice Nurse
- Physicians Assistant
- Physician
- Practical Nurse/Vocational Nurse
- Pharmacist
- Radiologic Technologist
- Registered Nurse
- Registered Radiologist Assistant
- Respiratory Therapist
- Industry(Medical Science Liaison/clinical specialist/ Research and Development)
- Other
Employment Setting*
- Hospital/Medical Center
- Ambulatory Care
- Skilled Nursing Facility
- Public Health Care
- Home Infusion
- Military
- Hospice Care
- Industry/Manufacturer (Clinicians only)
- Emergency Medical Services
- Pharmacy
- Other
Who is paying for your certification*
- I am paying with my own funds
- My employer is paying
- I will be reimbursed by my employer upon successful certification
- Scholarship
How did you hear about the VA-BC™ exam?*
- Association for Vascular Access
- Colleague recommendation
- Job requirement
- E-mail
- Facebook
- LinkedIn
- Twitter
- Online search
Race
- American Indian/Alaska Native
- Asian
- Black/African American
- Hispanic or Latino
- Native Hawaiian or Other Pacific Islander
- Caucasian/White
- Other
- Do not care to respond
Gender
- Male
- Female

Save and Continue Later

Untitled
- First Choice
- Second Choice
- Third Choice

Save and Continue Later

Untitled
- First Choice
- Second Choice
- Third Choice
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Save and Continue Later

Getting Certified
Recertification
Industry Program

Dates, Deadlines and Fees
Frequently Asked Questions
Volunteer

Contact Us
Privacy and Terms
AVA

Contact us at 404-760-8190 Toll free: 844-GOT-VABC (468-8222)|© 2020 The Vascular Access Certification Corporation (VACC) ncca