Submit a Request Form


The request for contact hours needs to be submitted at least 45 days prior to the proposed activity date. Only one request form per activity per calendar year is required. For example, if your activity is a monthly series, only one request form is needed for the calendar year. 

  • A Nurse Planner from the Provider Unit is required to assess whether appropriate educational design principles are used and processes are consistent with the requirements of the ANCC NCPD Accreditation Program. 
  • In addition, certain documents must be completed and reviewed prior to the event in order to fulfill the requirements necessary to award contact hours. 

What if you are not sure if your event is eligible to provide contact hours?  

  • Email and we will set up time to discuss your request and determine eligibility. 

What If I Am Not Sure of My Event Dates?

You may not know the exact date of your event when you submit your request, which is perfectly fine. In the event you do not know the date, please select the first day of the month you think the event will occur in your best judgment.


  • In your best judgment your upcoming event will occur in October.
  • Please select October 1 as your activity date.

What Happens When You Submit a Request for Contact Hours?

Your request will be triaged for eligibility by the Accredited Provider Program Director (APPD). A member of the Provider Unit team will reach out to you if clarification is needed, and then eligibility will be determined within 5 days of your submission. 

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