Criminal History Disclosure

Individuals requesting pre-application must submit current and valid documentation related to any previous criminal misdemeanor or felony where the individual has been convicted, has pled guilty, or has pled nolo contendere (no contest). If for any reason CCI determines, at its sole discretion, that information provided is or becomes incomplete or inaccurate, CCI may revoke any pre-application determinations.


Documentation Requirements

Individuals disclosing criminal matters must submit current and valid documentation related to any previous criminal misdemeanor or felony where the individual has been convicted, has pled guilty, or has pled nolo contendere (no contest). Documentation includes:

  1. Written Explanation
    A typed explanation, in the applicant’s own words, pertaining to the events that led to any charges, convictions, or criminal proceedings.
  2. Court Documentation
    Official documentation confirming criminal proceedings, charges filed, date, jurisdiction in which the event occurred, the sentence or conditions imposed, and the status of the conditions of the court.
  3. Probation Status (if applicable)
    An official letter from your probation or parole officer is required. This letter must be typed on official letterhead and must include the telephone number of the probation or parole officer.
  4. Proof of Completion of Probation or Parole
    Copies of official court release documents must be provided. This documentation must be on official court stationery.
  5. Court-Ordered Programs (if applicable)
    Documentation of completion of any court-ordered community service, counseling, or work release programs.
  6. Name Change Documentation (if applicable)
    Documentation of any name change if the name referenced on supporting documentation differs from the name provided on this pre-application.
  7. Letters of Recommendation
    Letters of recommendation from at least one employer, educational instructor, probation/parole officer, or clergy member. Letters of recommendation will NOT be accepted from family members.

Adverse Licensing or Certification Decisions

Individuals disclosing adverse decisions by any state or professional licensing, registration, or certification board should submit a written explanation that includes the date of the decision, the body that issued the decision, and the reason for the decision.

If for any reason CCI determines, at its sole discretion, that information provided is or becomes incomplete or inaccurate, CCI may revoke any pre-application determinations.

Note: CCI reserves the right to request additional supporting documentation, including additional letters of recommendation.


Submit Your Documentation

Please upload all required documentation below.

Documents can also be submitted by email or mail:

Email: applicant_support@cci-online.org

Mail:
Cardiovascular Credentialing International
3739 National Drive, Suite 202
Raleigh, NC 27612