Certified Hospice and Palliative Nurse (CHPN) Application

Advance Your Career in Hospice and Palliative Care with CHPN Certification

The Certified Hospice and Palliative Nurse (CHPN) credential represents the gold standard in end-of-life nursing care. This comprehensive application form streamlines the certification process for registered nurses seeking to validate their expertise in hospice and palliative care, making it easier for certification boards, healthcare organizations, and professional associations to manage applications efficiently.

Why This Form Template Matters for Healthcare Professionals

Hospice and palliative care nurses play a critical role in providing compassionate, skilled care to patients facing serious illness and end-of-life transitions. The CHPN certification validates specialized knowledge in pain and symptom management, psychosocial support, ethical decision-making, and interdisciplinary collaboration. This application template ensures that certification bodies can thoroughly evaluate candidates' qualifications while providing nurses with a clear, professional path to credentialing.

Built with Paperform, this CHPN application form offers healthcare organizations, nursing boards, and professional certification bodies a streamlined alternative to cumbersome PDF applications and fragmented email processes. The form guides applicants through each requirement—from RN license verification and clinical experience documentation to competency self-assessment and exam registration—creating a complete application package in one secure submission.

Key Features for Certification Boards and Healthcare Organizations

This template includes:

• License and credential verification with fields for RN license numbers, state of licensure, and expiration dates
• Clinical experience documentation capturing hours in hospice/palliative care settings, patient populations served, and practice settings
• Competency assessment sections covering pain management, symptom control, psychosocial care, and end-of-life communication
• Educational background including nursing degree information and specialized palliative care training
• Professional development tracking for continuing education hours and relevant certifications
• Employment verification with supervisor contact information for experience validation
• Exam registration including testing accommodation requests and preferred testing locations
• Supporting document upload for transcripts, licenses, and employment verification letters
• Conditional logic that adapts questions based on years of experience and practice settings

The form uses conditional logic to show relevant questions based on applicants' backgrounds—for example, displaying additional documentation requirements for nurses with non-traditional palliative care experience or requesting specific competency details for those working in pediatric hospice settings.

Perfect for Healthcare Certification Bodies and Professional Associations

This form template serves multiple healthcare organizations:

Nursing Certification Boards: Process CHPN applications with complete documentation, automated eligibility screening, and structured competency verification that simplifies review workflows.

Healthcare Organizations: Facilitate internal certification support programs by collecting comprehensive application data to guide nurses through the CHPN process and track institutional certification rates.

Professional Nursing Associations: Offer members a professional application experience that reflects the importance of specialty certification while gathering data on workforce development needs.

Palliative Care Programs: Support staff development by streamlining the certification application process and maintaining records of team credentials and specialization levels.

Streamlined Workflows with Stepper Integration

Beyond data collection, Paperform integrates seamlessly with Stepper to automate post-submission workflows. When a nurse submits their CHPN application, Stepper can:

• Send confirmation emails with application tracking numbers and next steps
• Route applications to review committees based on applicant location or specialty area
• Trigger verification requests to nursing boards for license validation
• Schedule follow-up reminders for incomplete applications or missing documentation
• Update applicant tracking systems or CRMs with submission data
• Notify exam coordinators when applications are approved for testing
• Generate eligibility letters and exam authorization documents

This automation reduces administrative burden on certification staff while ensuring applicants receive timely communication throughout the review process.

Supporting Documents with Integrated eSignatures

Many CHPN applications require signed attestations, supervisor verifications, or employment confirmations. With Papersign, you can automatically convert submitted applications into professional documents requiring digital signatures from applicants, supervisors, or verification sources—keeping everything connected to the original application for seamless audit trails.

Designed for Healthcare Professionals and Certification Staff

The form balances thoroughness with user experience. Nurses encounter a professional, organized application that clearly outlines requirements and guides them through complex competency questions. Certification reviewers receive structured, complete applications with all necessary documentation, reducing back-and-forth communication and accelerating the approval process.

With Paperform's SOC 2 Type II compliance and robust security features, sensitive healthcare information—including license numbers, employment details, and personal health information—remains protected throughout the application process.

Customizable for Your Certification Program

While this template follows standard CHPN certification requirements, it's fully customizable to match your specific:

• Institutional branding and visual identity
• Application review criteria and scoring systems
• State-specific licensing requirements
• Specialty focus areas (pediatric, geriatric, oncology palliative care)
• Fee structures and payment processing
• Documentation submission preferences

Whether you're a national nursing certification board processing thousands of CHPN applications annually or a regional healthcare system supporting nurses in achieving specialty credentials, this template provides the professional foundation you need.

Get started today and transform your CHPN certification application process from a paper-based administrative challenge into a streamlined, professional experience that honors the vital work of hospice and palliative care nurses.