All Substantive Changes are $200
Change to President/CEO*
*If you prefer a paper form, please submit this form instead-Change to President/CEO
Change in Dean*
**If you prefer a paper form, please submit this form instead-Change in Dean
Change in Program Director (PD) Entry Into Professional Practice
Provide the following seven (7) documents:
1. Completed “Change in PD” form
2. Copy of the institution’s Letter of Appointment and Acceptance
The letter(s) must contain at least the following items:
a. Signature of the President/CEO or Dean/Administrator
b. Position Title
c. The effective (start) date
d. A guarantee of full-time faculty appointment
NOTE: If you do not have a “Letter of Appointment and Acceptance” and need to create one, you may use this template.
3. Completed “CoARC CV Outline“
4. Copy of current state license (with expiration date)
5. Copy of current NBRC RRT certificate or NBRC Credential Verification Letter
6. Official transcript of highest degree (a scanned copy is acceptable)
7. CoARC Key Personnel Training program certificate of completion, if applicable (if not available, the individual has 24 months from the date of appointment to complete the training)
Return all seven (7) documents via email to: shelley@coarc.com
Change in Program Director (PD) Degree Advancement
Provide the following seven (7) documents:
1. Completed “Change in PD – DA” form
2. Copy of the institution’s Letter of Appointment and Acceptance
The letter(s) must contain at least the following items:
a. Signature of the President/CEO or Dean/Administrator
b. Position Title
c. The effective (start) date
d. A guarantee of full-time faculty appointment
NOTE: If you do not have a “Letter of Appointment and Acceptance” and need to create one, you may use this template.
3. Completed “CoARC CV Outline“
4. Copy of current state license (with expiration date)
5. Copy of current NBRC RRT certificate or NBRC Credential Verification Letter
6. Official transcript of highest degree (a scanned copy is acceptable)
7. CoARC Key Personnel Training program certificate of completion, if applicable (if not available, the individual has 24 months from the date of appointment to complete the training)
Return all seven (7) documents via email to: shelley@coarc.com
Change in Director of Clinical Education (DCE) Entry Into Professional Practice
Provide the following seven (7) documents:
1. Completed “Change in DCE – Entry” form
2. Copy of the institution’s Letter of Appointment and Acceptance
The letter(s) must contain at least the following items:
a. Signature of the President/CEO or Dean/Administrator
b. Position Title
c. The effective (start) date
d. A guarantee of full-time faculty appointment
NOTE: If you do not have a “Letter of Appointment and Acceptance” and need to create one, you may use this template.
3. Completed “CoARC CV Outline“
4. Copy of current state license (with expiration date)
5. Copy of current NBRC RRT certificate or NBRC Credential Verification Letter
6. Official transcript of highest degree (a scanned copy is acceptable)
7. CoARC Key Personnel Training program certificate of completion, if applicable (if not available, the individual has 24 months from the date of appointment to complete the training)
Return all seven (7) documents via email to: shelley@coarc.com
Change in Medical Director/Co-Medical Director Entry Into Professional Practice
Provide the following five (5) documents:
1. Completed “Change in MD/Co-MD” form
2. Copy of the institution’s Letter of Appointment and Acceptance
The letter(s) must contain at least the following items:
a. Signature of the President/CEO or Dean/Administrator
b. Position Title
c. The effective (start) date
NOTE: If you do not have a “Letter of Appointment and Acceptance” and need to create one, you may use this template.
3. Curriculum vitae
4. Copy of current state license
5. Copy of board certificate(s)
Return all five (5) documents via email to: shelley@coarc.com
Change in Primary Sleep Specialist Instructor (PSSI)
Provide the following five (5) documents:
1. Completed “Change in Primary Sleep Specialist Instructor” form
2. Copy of the institution’s Letter of Appointment and Acceptance
The letter(s) must contain at least the following items:
a. Signature of the President/CEO or Dean/Administrator
b. Position Title
c. The effective (start) date
d. A guarantee of faculty appointment
NOTE: If you do not have a “Letter of Appointment and Acceptance” and need to create one, you may use this template.
3. Completed “CoARC CV Outline“
4. Documentation of valid credentials as a Sleep Disorders Specialist (CRT-SDS or RRT-SDS) or a Registered Polysomnographic Technologist (RPSGT)
5. Official transcript denoting at least the required degree (a scanned copy is acceptable)
Return all five (5) documents via email to: shelley@coarc.com
Change in Billing Contact*
**If you prefer a paper form, please submit this form instead-Change in Billing Contact
Change in Program Name*
**If you prefer a paper form, please submit this form instead-Change in Program Name
Change in Program Address*
**If you prefer a paper form, please submit this form instead-Change in Program Address
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