Fillable Printable I 905Instr
Fillable Printable I 905Instr
I 905Instr
Form I-905 Instructions 02/11/14 Y
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What Is the Purpose of This Application?
For an organization to apply for authorization to issue certificates to health care workers.
Instructions for Application for Authorization to Issue
Certification for Health Care Workers
Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
Form I-905
Who May File This Form?
An organization wishing to obtain authorization to issue certificates to health workers under section 212(a)(5)(C) or
section 212(r) of the Immigration and Nationality Act must file this application.
1. Which Occupations Require Certification?
The occupations requiring health care worker certification are:
A.
Licensed practical nurses, licensed vocational nurses, and registered nurses;
B.
Occupational therapists;
C.
Physical therapists;
D.
Speech language pathologists and audiologists;
E.
Medical technologists (clinical laboratory scientists);
F.
Physician assistants; and
G.
Medical technicians (clinical laboratory technicians).
You must submit a statement addressing how your organization meets the standards provided in these instructions. In
addition, by filing this application you agree to submit any information that U.S. Citizenship and Immigration Services
(USCIS) may request in order to determine your eligibility to issue certificates.
2. What Documents Do You Need to File With This Application?
After the application is filed, USCIS will review the application for completeness. If the application is complete, USCIS
will forward a copy of the application to the Secretary of Health and Human Services (HHS) for an opinion.
If the application is approved, it will be approved for 5 years. You must apply for reauthorization to issue certificates
before your authorized period of time expires. Your continued eligibility to issue certificates will be reviewed
periodically by USCIS.
After HHS provides an opinion, USCIS will render a decision on the application. You will be notified in writing of the
decision. If the application is denied, you will be provided with information on how the decision can be appealed.
How Will USCIS Process This Application?
Structure of the Organization
What Are the Standards to Obtain Authorization to Issue Certificates?
A. The organization must be independent of any organization that functions as a representative of the occupation or
profession in question or serves as or is related to a recruitment/placement organization.
1. The organization must be incorporated as a legal entity.
B. USCIS must not approve an organization that is unable to render impartial advice regarding an individual's
qualifications regarding training experience and licensure.
Form I-905 Instructions 02/11/14 Y
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(1) Policies and procedures; eligibility requirements and application processing; standards for granting certificates
and their renewal; examination content, development, and administration; examination cut-off scores, excluding
those pertaining to English language requirements; grievance and disciplinary processes; governing body and
committee meeting rules; publications about qualifying for a certificate and its renewal; setting fees for
applications and all other services provided as part of the screening process; funding spending and budget
authority related to the operation of the certification organization; ability to enter into contracts and grant
arrangements; ability to demonstrate adequate staffing and management resources to conduct the program(s)
including the authority to approve selection of, evaluate and initiate dismissal of the chief staff member.
(2) An organization whose fees are based on whether an applicant receives a visa may not be approved.
2. The organization must include the following representation in the portion of its organization responsible for overseeing
certification and, where applicable, examinations:
A. Individuals from the same health care discipline as the alien health care worker being evaluated who are eligible to
practice in the United States; and
B. At least one voting public member to represent the interests of consumers and protect the interests of the public at
large. The public member must not be a member of the discipline or derive significant income from the discipline,
its related organizations, or the organization issuing the certificate.
C. The organization must also be independent in all decision making matters pertaining to evaluations and/or
examinations that it develops including, but not limited to:
3. The organization must have a balanced representation such that the individuals from the same health care discipline,
the voting public members, and any other appointed individuals have an equal say in matters relating to credentialing
and/or examinations.
4. The organization must select representatives of the discipline using one of the following recommended methods, or
demonstrate that it has a selection process that meets the intent of these methods:
A. Be selected directly by members of the discipline eligible to practice in the United States;
B. Be selected by members of a membership organization representing the discipline or by duly elected representatives
of a membership; or
C. Be selected by a membership organization representing the discipline from a list of acceptable candidates supplied
by the credentialing body.
5. The organization must use formal procedures for the selection of members of the governing body which prohibit the
governing body from selecting a majority of its successors. Not-for-profit corporations which have difficulty meeting
this requirement may provide in their applications evidence that the organization is independent and free of material
conflicts of interest regarding whether an alien receives a visa.
6. The organization must be separate from the accreditation and educational functions of the discipline, except for those
entities recognized by the U. S. Department of Education as having satisfied the requirement of independence.
7. The organization must publish and make available a document that clearly defines the responsibilities of the
organization and outlines any other activities arrangements or agreements of the organization that are not directly
related to the certification of health care workers.
Resources of the Organization
1. The organization must demonstrate that its staff has the knowledge and skills necessary to accurately assess the
education, work experience, licensure of health care workers, and the equivalence of foreign educational institutions
comparable to those of U.S. trained health care workers and institutions.
Form I-905 Instructions 02/11/14 Y
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Candidate Evaluation and Testing Mechanisms
1. The organization must publish and make available a comprehensive outline of the information, knowledge, or
functions covered by the evaluation/examination process including information regarding testing for English language
competency.
2. The organization must use reliable evaluation examination mechanisms to evaluate individual credentials and
competence that is objective, fair to all candidates, job related, and based on knowledge and skills needed in the
discipline.
3. The organization must conduct ongoing studies to substantiate the reliability and validity of the evaluation/examination
mechanisms.
4. The organization must implement a formal policy of periodic review of the evaluation/examination mechanism to
ensure ongoing relevance of the mechanism with the respect to knowledge and skills needed in the discipline.
5. The organization must use policies and procedures to ensure that all aspects of the evaluation/examination procedures,
as well as the development and administration of any tests, are secure.
6. The organization must institute procedures to protect against falsification of documents and misrepresentation
including a policy to request each applicant's transcript(s) and degree(s) directly from the educational licensing
authorities.
7. The organization must establish policies and procedures that govern the length of time the applicant's records must be
kept in their original format.
8. The organization must publish and make available, at least annually, a summary of all screening activities for each
discipline including at least the number of applications received, number of applicants evaluated, number receiving
certificates, number who failed, and the number receiving renewals.
Responsibilities to Applicants Applying for an Initial Certificate or Renewal
1. The organization must not discriminate among applicants as to age, sex, race, religion, national origin, disability, or
marital status and must include a statement of nondiscrimination in announcements of the evaluation examination
procedures and renewal certification process.
2. The organization must provide all applicants with copies of formalized application procedures for evaluation
examination and must uniformly follow and enforce such procedures for all applicants. Instructions must include
standards regarding English language requirements.
3. The organization must implement a formal policy for the periodic review of eligibility criteria and application
procedures to ensure that they are fair and equitable.
4. Where examinations are used, the organization must provide competently proctored examination sites at least once
annually.
4. The organization must have the resources to publish and make available general descriptive materials on the
procedures used to evaluate and validate credentials including eligibility requirements, determination procedures,
examination schedules, locations, fees, reporting of results, and disciplinary and grievance procedures.
3. If the health care field is one for which a majority of the States require a predictor test, the organization must
demonstrate the ability to conduct examinations in those countries with educational and evaluation systems
comparable to the majority of States.
2. The organization must demonstrate the availability of financial and material resources to effectively and thoroughly
conduct regular and ongoing evaluations on an international basis.
Form I-905 Instructions 02/11/14 Y
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An organization undertaking the administration of a predictor examination, or a licensing or certification examination,
must demonstrate the ability to conduct such examination fairly and impartially.
Ability to Conduct Examinations Fairly and Impartially
2. The organization must also evaluate the licensing and credentialing system(s) of each country or licensing jurisdiction
to determine which systems are equivalent to that of the majority of the licensing jurisdiction in the United States.
Criteria for Awarding and Governing Certificate Holders
1. The organization must issue a certificate after the education, experience, license, and English language competency
have been evaluated and determined to be equivalent to their U. S. counterparts. In situations where a U. S. nationally
recognized licensure or certification examination, or a test predicting the success on the licensure or certification
examination, is offered overseas the applicant must pass the examination or predictor test prior to receiving
certification. Passage of a test predicting the success on the licensure or certification examination may be accepted
only if a majority of the states (and Washington, D.C.) licensing the profession in which the alien intends to work
recognize such a test.
2. The organization must have policies and procedures for the revocation of certificates at any time if it is determined
that the certificate holder was not eligible to receive the certificate at the time it was issued. If the organization
revokes an individual's certificate, it must notify USCIS, via the Nebraska Service Center, and the appropriate state
regulatory authority with jurisdiction over the individual's health care profession. The organization may not re-issue a
certificate to an individual whose certificate has been revoked.
Criteria for Maintaining Accreditation
1. The organization must advise USCIS of any changes in purpose, structure, or activities of the organization or its
program(s).
2. The organization must advise USCIS of any major changes in the evaluation of credentials and examination techniques,
if any, or in the scope or objectives of such examinations.
Maintenance of Comprehensive and Current Information
1. The organization must maintain comprehensive and current information of the type necessary to evaluate foreign
educational institutions and accrediting bodies for purposes of ensuring that the quality of foreign educational
programs is equivalent to those training the same occupation in the United States. The organization must examine,
evaluate, and validate the academic and clinical requirements applied to each country's accrediting body or bodies, or
in countries not having such bodies, of the educational institution itself.
10. The organization must provide all qualified applicants with a certificate in a timely manner.
9. The organization must publish due process policies and procedures for applicants to question eligibility
determinations, examination or evaluation results, and eligibility status.
7. The organization must implement policies and procedures to ensure that each applicant's examination results are held
confidential and delineate the circumstances under which the applicant's certification status may be made public.
8. The organization must have a formal policy for renewing the certification if an individual's original certification has
expired before the individual first seeks admission to the United States or applies for adjustment of status. Such
procedures must be restricted to updating information on licensure to determine the existence of any adverse action
and the need to re-establish English competency.
6. The organization must provide applicants who failed either the evaluation or examination with information on general
areas of deficiency.
5. The organization must report examination results to applicants in a uniform and timely fashion.
Form I-905 Instructions 02/11/14 Y
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What Is Our Authority for Collecting This Information?
We request the information on this form to carry out the immigration laws contained in Title 8, U.S. Code, Section 1186.
The organization, or individuals on behalf of the organization, do not have to give this information. However, refusal to
give some or all of it may result in denial of the application.
We need this information to determine whether a person is eligible for immigration benefits. The information the
organization or individuals on behalf of the organization provides may also be disclosed to other Federal, State, local, and
foreign law enforcement and regulatory agencies.
USCIS provides forms free of charge through the USCIS Web site. In order to view, print, or fill out our forms, you
should use the latest version of Adobe Reader, which you can download for free at //get.adobe.com/reader/
.
Copies. You may submit a legible photocopy of documents requested, unless the instructions specifically state that you
must submit an original document. If you submit original documents when not required, the documents may remain a part
of the record, and USCIS will not automatically return them to you.
Translations. If you submit a document with information in a foreign language, you must also submit a full English
translation. The translator must certify that the English language translation is complete and accurate, and that he or she is
competent to translate from the foreign language into English.
Each application must be accompanied by the appropriate filing fee. (See the What Is the Filing Fee section of these
instructions.)
General Instructions
If your application is approved, it will be approved for a period of 5 years. USCIS will conduct a review of your
organization every 5 years to ensure continued compliance with the standards described. The review will occur
concurrent with the adjudication of your request for reauthorization to issue health care worker certificates. If USCIS
determines that you are not complying with the terms of authorization, or if other adverse information is brought to
USCIS's attention, USCIS may proceed to terminate your authorization to issue health care worker certificates.
Are There Any Limitations If This Application Is Approved?
5. The organization must be in ongoing compliance with other policies specified by USCIS.
4. The organization must establish performance outcome measures that track the ability of the certificate holders to pass
U. S. licensure or certification examinations.
The purpose of the process is to ensure that certificate holders pass U. S. licensure or certification examinations at the
same pass rate as graduates of the U. S. programs. Failure to establish such measures, or having a record showing an
inability of persons granted certificates to pass U. S. licensure examinations at the same rate as graduates of U. S.
programs, may result in a ground for termination of approval. Information regarding the passage rates of certificate
holders must be maintained by the organization and provided to HHS on an annual basis, to USCIS as part of the 5-
year reauthorization application, and at any other time upon request by HHS or USCIS.
3. The organization must, upon request, submit to USCIS, or any organization designated by USCIS, information
requested of the organization and its programs for use in investigating allegations of noncompliance with standards
and for general purposes of determining continued approval as an independent credentialing organization.
1. Type or print legibly in black ink.
How To Fill Out Form I-905
Form I-905 Instructions 02/11/14 Y
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Use the following guidelines when you prepare your check or money order for Form I-905:
What Is the Filing Fee?
2. Make the check or money order payable to U.S. Department of Homeland Security.
The filing fee for Form I-905 is $230.
1. The check or money order must be drawn on a bank or other financial institution located in the United States and must
be payable in U.S. currency; and
NOTE: Spell out U.S. Department of Homeland Security; do not use the initials "USDHS" or "DHS."
3. If you live outside the United States, contact the nearest U.S. Embassy or U.S. Consulate for instructions on the
method of payment.
Please see our Web site at www.uscis.gov/I-905 or call our National Customer Service Center at 1-800-375-5283 for the
most current information about where to file this benefit request. For TDD (deaf or hard of hearing) call:
1-800-767-1833.
Where to File?
This section must contain the original signature of the person who completed this form, if other than the applicant filing
this form. If the person who completed this form is associated with a business or organization, you should complete the
business/organization name and address sections. If the person completing this form is an attorney or accredited
representative, he or she must submit a completed Form G-28, Notice of Entry of Appearance as Attorney or Accredited
Representative, along with this application/petition.
Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the
Applicant
Contact Information, Certification, and Signature of Interpreter
If you used an interpreter to read the instructions and complete the questions on this form, the interpreter must fill out this
section, provide the name of his or her business/organization, the business/organization's address, his or her daytime
telephone number, and his or her email address. The interpreter must also sign and date the form.
Statement, Certification, Signature, and Contact Information of the Applicant
Select the box that indicates if you filled out this form or if someone interpreted this form for you. Additionally, if
applicable, select the box that indicates if someone filled out this form for you. Every application must contain the
original signature of the applicant. Sign and date the form and provide your daytime telephone number, mobile telephone
number, and email address.
3. Answer all questions fully and accurately. If an item is not applicable or the answer is “none,” type or print “N/A,”
unless otherwise directed.
2. If you need extra space to complete any item within this application, attach a separate sheet of paper; type or print your
company or organization name at the top of each sheet; indicate the Page Number, PartNumber, and Item Number
to which your answer refers; and sign and date each sheet.
How to Check If the Fees Are Correct
The form fee on this form is current as of the edition date appearing in the lower left corner of this page. However,
because USCIS fees change periodically, you can verify if the fees are correct by following one of the steps below:
1. Visit our Web site at www.uscis.gov, select "FORMS" and check the appropriate fee; or
2. Call the USCIS National Customer Service Center at 1-800-375-5283 and ask for fee information. For TDD (deaf or
hard of hearing) call: 1-800-767-1833.
Form I-905 Instructions 02/11/14 Y
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We ask for the information on this form, and associated evidence, to determine if you have established eligibility for the
immigration benefit for which you are filing. Our legal right to ask for this information can be found in the Immigration
and Nationality Act, as amended. We may provide this information to other government agencies. Failure to provide this
information, and any requested evidence, may delay a final decision or result in denial of your Form I-905.
Privacy Act Notice
Penalties
In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.
If you knowingly and willfully falsify or conceal a material fact or submit a false document with this form, we will deny
the form and may deny any other immigration benefit.
Address Changes
You must inform USCIS if you change your address. For information on filing a change of address, go to the USCIS
Web site at www.uscis.gov/addresschange or contact the USCIS National Customer Service Center at 1-800-375-5283.
For TDD (deaf or hard of hearing) call: 1-800-767-1833.
USCIS Forms and Information
Instead of waiting in line for assistance at your local USCIS office, you can now schedule an appointment through the
USCIS Internet-based system, InfoPass. To access the system, visit the USCIS Web site at infopass.uscis.gov/. Use the
InfoPass appointment scheduler and follow the screen prompts to set up your appointment. InfoPass generates an
electronic appointment notice that appears on the screen.
To ensure you are using the latest version of this form, visit the USCIS Web site at www.uscis.gov
where you can obtain
the latest USCIS forms and immigration-related information. If you do not have Internet access, you may order USCIS
forms by calling our toll-free number at 1-800-870-3676. You may also obtain forms and information by calling the
USCIS National Customer Service Center at 1-800-375-5283. For TDD (deaf or hard of hearing) call: 1-800-767-1833.
Decision. The decision on Form I-905 involves a determination of whether you have established eligibility for the
requested benefit. USCIS will notify you of the decision in writing.
Requests for More Information or Interview. We may request more information or evidence from you or we may
request that you appear at a USCIS office for an interview. We may also request that you provide the originals of any
copies you submit. We will return these originals when they are no longer needed.
Initial Processing. Once USCIS accepts your application, we will check it for completeness. If you do not completely
fill out the form, we may deny your application.
Processing Information
Any form that is not signed or accompanied by the correct fee will be rejected with a notice that the form is
deficient. You may correct the deficiency and resubmit the form. An application is not considered properly filed until
accepted by USCIS.
