As an Academy Credentialing applicant or certificant:
- I understand and accept all Academy Credentialing policies, procedures and requirements as detailed on this application, and on any related electronic or paper communication that has been furnished to me or made publicly available.
- I agree to conduct myself in accordance with Academy standards, Academy by-laws as currently constituted and as amended, and in accordance with any decisions or policies issued by the Academy Board of Directors, the Credentialing Committee, the program director, or their authorized representatives. (These parties shall herein be referred to collectively as “the Academy”.) I also agree to abide by the Academy Code of Professional Ethics, as set forth on the Academy website.
- I agree that if the Academy determines that my compliance with an Academy Credentialing program requirement requires additional explanation and/or supporting documents, I Iwill provide a complete and accurate response and true copies of any requested information to the Academy in a timely manner. I agree that refusal or failure to provide true, timely and complete responses to questions on the application or other Academy requests for information may lead to denial of testing eligibility, or revocation of an existing credential. I understand that a percentage of each year¹s applications are audited, and I may be contacted to furnish full documentation of any or all declarations made in my application.
- I agree that the Academy has the right to communicate with any person, governmental agency, or organization to review or confirm the information in my application or any other information related to my application. I agree the Academy may investigate my professional standing, and I agree to provide or authorize the release of any information requested by the Academy for such review and confirmation. I agree that the Academy has the right to communicate with any person, governmental agency, or organization to review or confirm the information in my application or any other information related to my application. I agree the Academy may investigate my professional standing, and I agree to provide or authorize the release of any information requested by the Academy for such review and confirmation.
- I agree that all materials that I submit to the Academy will become the property of the Academy, and that the Academy is not required to return any of these materials to me.
- I agree that the information related to my participation in the Academy Credentialing process may be used in an anonymous manner for research purposes, and for other lawful purposes which do not reveal my identity, as authorized by the Board of Directors.
- I agree that upon designation as an HIV Specialist™, HIV Expert™ or HIV Pharmacist™ by the Academy, my name (at a minimum) and certain other optional biographical data concerning me (which I may designate) will be considered public information, and will be made available to the public as such.
- I agree that my HIV Specialist™, HIV Expert™ or HIV Pharmacist™ credential does not imply licensure, registration, or authorization to practice HIV or AIDS-related specialty medicine, research or pharmacy, or to engage in any related or similar activities.
- I agree that I shall not engage in any form of dishonest behavior with regard to completion of an HIV Credentialing Exam. I understand that such dishonesty includes, but is not limited to, the following: copying the work of another candidate or other individual, or representing another candidate¹s or other individuals¹ work as my own work; having another individual take or otherwise assist me in completing the examination; providing unauthorized materials or information to others during the examination; or any other activity which may provide me or another candidate with an unfair testing advantage.
- I understand and accept that the contents of all Academy examinations and any related materials shall be held strictly confidential, and that the entire ownership interest in the exam and its attendant materials is held by the Academy and is controlled by the Academy Board of Directors and the Credentialing Committee. I accept that my possession of an Academy examination and any related materials is for the sole purpose of completing the exam, and that no other person, group of individuals, corporation, or other entity shall have any license or permission to view or use any part of the exam or related materials for any purpose. I agree not to discuss, share, distribute, reproduce in any manner, or otherwise disclose the specific content of any Academy examination question, answer or examination related document to any individual or entity.
- I understand and accept that, in appropriate circumstances as determined by the Academy or its representatives, the Academy reserves the exclusive rights to suspend, cancel, revoke, or otherwise terminate an applicant¹s eligibility, credentialed status or privileges related to the Academy Credentialing process. The Academy may, at its own discretion, suspend or terminate a credential, candidate examination privileges, exam scoring, or other exam evaluation activities. Among other circumstances, the suspension or termination of examination or other privileges, and the issuance of remedial and/or disciplinary actions will be authorized where: a specialty credential application or examination irregularity or impropriety occurs; a candidate or credentialed provider engages in misconduct or other conduct contrary to Academy policies and requirements; or credentialing eligibility information or examination, scoring or evaluation results are determined to be invalid for any reason.
- I agree that disputes related to any issue surrounding my application, eligibility, audits, examinations, completion deadlines, results (scores), retest policies and/or fee policies shall be initiated in writing to the Academy, and will be resolved solely and exclusively at the discretion of the Academy Board of Directors and/or the Credentialing Committee, whose decisions shall be final. All requests for consideration will be addressed within 30 days, unless the issue requires additional time to resolve or investigate, in which case, a dispute will still be acknowledged within 30 days and will include explanation for additional delays on final resolution.
- I certify that the information and declarations I have provided in this application are accurate and complete, including my statement of CME/CEU/CE. I understand that any misrepresentations or incorrect information provided herein can result in sanctions, including exam ineligibility, or revocation of an existing credential after it is awarded.
- I fully release, discharge and indemnify the Academy, its directors, officers, examiners, employees, attorneys, representatives and agents from all liability and claims that may arise out of, or be related to, my professional practice or related clinical or non-clinical activities.
- I fully release, discharge and indemnify the Academy, its directors, officers, examiners, employees, attorneys, representatives and agents from any actions, suits, obligations, damages, claims, or demands arising out of, or in connection with: this application, subsequent Academy examination activities, or any other action taken by the Academy Board of Directors and the Academy with regard to credential issuance; including but not limited to all actions related to ethics policies and matters. I understand and agree that any decision concerning my current or future qualifications and eligibility for any Academy Credential rests within the sole and exclusive discretion of the Academy Board of Directors and Credentialing Committee, and that these decisions are final.