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Instructions pour le formulaire I-905, Demande d'autorisation de délivrer des certificats aux travailleurs de la santé

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Instructions for Application for Authorization to Issue  
Certification for Health Care Workers  
Form I-905  
Department of Homeland Security  
U.S. Citizenship and Immigration Services  
What Is the Purpose of This Application?  
For an organization to apply for authorization to issue certificates to health care workers.  
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:  
Licensed practical nurses, licensed vocational nurses, and registered nurses;  
Occupational therapists;  
Physical therapists;  
Speech language pathologists and audiologists;  
Medical technologists (clinical laboratory scientists);  
Physician assistants; and  
Medical technicians (clinical laboratory technicians).  
2. What Documents Do You Need to File With This Application?  
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.  
How Will USCIS Process 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.  
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.  
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.  
What Are the Standards to Obtain Authorization to Issue Certificates?  
Structure of the Organization  
1. The organization must be incorporated as a legal entity.  
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.  
B. USCIS must not approve an organization that is unable to render impartial advice regarding an individual's  
qualifications regarding training experience and licensure.  
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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:  
(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.  
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.  
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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.  
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.  
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.  
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  
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  
3. The organization must conduct ongoing studies to substantiate the reliability and validity of the evaluation/examination  
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  
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  
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5. The organization must report examination results to applicants in a uniform and timely fashion.  
6. The organization must provide applicants who failed either the evaluation or examination with information on general  
areas of deficiency.  
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.  
9. The organization must publish due process policies and procedures for applicants to question eligibility  
determinations, examination or evaluation results, and eligibility status.  
10. The organization must provide all qualified applicants with a certificate in a timely manner.  
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.  
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.  
Ability to Conduct Examinations Fairly and Impartially  
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.  
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  
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.  
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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.  
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.  
5. The organization must be in ongoing compliance with other policies specified by USCIS.  
Are There Any Limitations If This Application Is Approved?  
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.  
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.  
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.  
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.  
General Instructions  
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  
Each application must be accompanied by the appropriate filing fee. (See the What Is the Filing Fee section of these  
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.  
How To Fill Out Form I-905  
1. Type or print legibly in black ink.  
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Form I-905 Instructions 11/10/20  
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, Part Number, and Item Number  
to which your answer refers; and sign and date each sheet.  
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.  
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.  
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.  
Contact Information, Declaration, and Signature of the Person Preparing this Application, If Other Than the  
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.  
Where to File?  
Please see our Web site at 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:  
What Is the Filing Fee?  
The filing fee for Form I-905 is $230.  
Use the following guidelines when you prepare your check or money order for Form I-905:  
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  
2. Make the check or money order payable to U.S. Department of Homeland Security.  
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.  
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, 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.  
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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.  
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.  
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.  
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.  
USCIS Forms and Information  
To ensure you are using the latest version of this form, visit the USCIS website at where you can obtain  
the latest USCIS forms and immigration-related information. If you do not have internet access, you may call the USCIS  
Contact Center at 1-800-375-5283 and ask that we mail a form to you. The USCIS Contact Center provides information  
in English and Spanish. For TTY (deaf or hard of hearing) call: 1-800-767-1833.  
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 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.  
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.  
In addition, you will face severe penalties provided by law and may be subject to criminal prosecution.  
Privacy Act Notice  
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.  
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