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RST Exam Application
RST Exam Application
Andrew Posadzy
2018-11-19T20:44:24+00:00
RST Exam Application
Personal Information (Required)
First Name
*
Middle
Last Name
*
Gender
Male
Female
Date of Birth
*
Date Format: MM slash DD slash YYYY
Primary Phone
*
Email
*
Eligibility Status
Basic Cardiac Life Support Certified
*
I am currently certified for Basic Cardiac Life Support
Basic Cardiac Life Support Certification
*
(All candidates must be certified - attach a copy of unexpired card below)
Eligibility Pathways
Choose one of the following eligibility pathways below.
Pathway
*
Certificate or Associate's Degree Program (Pathway A)
A-STEP Program (Pathway B)
Other Health Professional (Pathway C)
RPSGT Credential (Pathway D)
On-the-Job Training in an AASM-Accredited Sleep Facility (Pathway E)
Pathway A Attachments
Certificate or Associate's Degree Program (Pathway A)
*
Choose ONE of the following and attach copy of certificate below.
CoA PSG Program
CoA END with PSG Add-on Program
CoARC with PSG Add-on Program
Certificate or Associate's Degree Program
*
Attach a copy of a CoA PSG Program, CoA END with PSG Add-on Program, or CoARC with PSG Add-on Program certificate.
Pathway B Attachments
Evidence of highest level of education achieved
*
High school diploma or degree certificate
80-hour Didactic Accredited Sleep Technology Education Program (A-STEP) Introductory Program
*
Successful completion of the 80-hour didactic Accredited Sleep Technology Education Program (A-STEP) Introductory Program
Completion of the full series of online A-STEP Modules
*
Successful completion of the full series of online A-STEP modules
Completion of 50 overnight sleep studies
*
Successful completion of 50 overnight sleep studies including 20 with continuous positive airway pressure and at least one MSLT within the last 6 months to 3 years (with written verification by a Board Certified Sleep Specialist or Medical Director of an AASM-accredited Sleep Disorders Center). Please use the
Verification of Clinical Experience form.
Completion of the inter-scorer reliability requirement
*
Successful completion of the ABSM sleep scoring proficiency examination (attach certificate) or by meeting threshold in the inter-scorer reliability program of an AASM-accredited sleep disorders center for a minimum of 3 months. Use the Verification of Clinical Experience form if you do not have a certificate.
Pathway C Attachments
Health Professional Credential
*
Please enter your health professional credential below : (acceptable credentials are MD, DO, PhD, PsyD, PA, NP, RN, LPN, CRT, RRT, R.EEG T., R.EP T, or EMT-P)
Credential Certificate
*
Certificate must include current dates
Completion of 25 overnight sleep studies
*
Successful completion of 25 overnight sleep studies including 10 with continuous positive airway pressure and at least one MSLT within the last 3 months to 2 years (with verification by a Board Certified Sleep Specialist or Medical Director of an AASM-accredited Sleep Disorders Center). Please use the
Verification of Clinical Experience form.
Completion of the inter-scorer reliability requirement
*
Successful completion of the ABSM sleep scoring proficiency examination (attach certificate) or by meeting threshold in the inter-scorer reliability program of an AASM-accredited sleep disorders center for a minimum of 3 months. Use the Verification of Clinical Experience form if you do not have a certificate.
Pathway D Attachments
Evidence of highest level of education achieved
*
High school diploma or degree certificate
RPSGT Credential
*
Pathway E Attachments
Evidence of highest level of education achieved
*
High school diploma or degree certificate
Completion of the full series of online A-STEP Modules
*
Successful completion of the full series of online A-STEP modules
Completion of the inter-scorer reliability requirement
*
Successful completion of the ABSM sleep scoring proficiency examination (attach certificate) or by meeting threshold in the inter-scorer reliability program of an AASM-accredited sleep disorders center for a minimum of 3 months. Use the Verification of Clinical Experience form if you do not have a certificate.
Employment in an AASM-accredited sleep facility for at least one year
*
Employment in an AASM-accredited sleep facility for at least one year (with written certification by a Board Certified Sleep Specialist or Medical Director of an AASM-accredited Sleep Disorders Facility). Knowledge of topics covered in the 80-hour Didactic Accredited Sleep Technology Education Program (A-STEP) Introductory Program Please use the
Verification of Clinical Experience form.
Attestation
*
By typing your full name below, you hereby declare the following: That I have read and will adhere to the Examination Handbook. That all information contained in this application and all documentation submitted with or in support of the application is true. I understand and agree that any misrepresentation of said facts will results in automatic disqualification to sit for the examination or revocation of the certification obtained.
Method of Payment
Examination Fee
*
Price:
$250.00
Total
$0.00
Billing Address
*
This address must be associated with your credit card.
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