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Clean Needle Technique Course: FAQs

Question 1: What is the Clean Needle Technique course?

Answer: The Clean Needle Technique (CNT) course is a one-day program that includes a lecture, a demonstration, and written and practical examinations. The material for this course is based on the most current edition of the Clean Needle Technique Manual, which is now in the 7th Edition and is available on the CCAOM website as a free PDF download. This course was originally developed in 1985 by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) as part of a program of certification of professional competence to practice acupuncture safely and effectively. In 1990, the NCCAOM transferred the responsibility for administering the CNT course to the CCAOM. Over the years, the CCAOM has continued to develop and improve the rigorous, state-of-the-art CNT course, which contains both theoretical and practical components.

Question 2: What is the purpose of the CNT Course?

Answer: The basic rationale upon which the CCAOM’s CNT course is premised is that there is a need for a national standard in the area of clean needle safety to ensure public safety by preventing clinical accidents. The need for a national certification standard in needle safety is strongly supported not only by the national association of AOM colleges (CCAOM), but also by the national accrediting agency for the AOM profession (ACAOM). The CCAOM’s CNT course serves the interests of public safety by ensuring that graduates of AOM programs, both domestic and foreign, are informed of and have demonstrated competency in a uniform national standard of needle safety.

Question 3: Who is eligible to take the CNT course?

Answer: The CNT course is designed for the following categories of individuals:

(1) currently enrolled AOM students whose program of study requires them to take the CNT course; (2) AOM students or graduates who wish to receive NCCAOM certification; (3) AOM students, graduates or other practitioners whose state licensing board requires completion of the CNT course. In addition, some insurance carriers or employers may require completion of a recent CNT course, and some state boards governing the practice of detoxification (NADA) specialists may require completion of the national CNT course as well.

Question 4: Why should I take the CNT course?

Answer: National certification in the field of acupuncture by NCCAOM requires an applicant to have successfully completed the CCAOM CNT course. Although needling technique and safety is a required course at accredited acupuncture schools in the United States, the NCCAOM as well as most state licensing boards recognize that independent verification of CNT competency by those wishing to practice acupuncture is essential in the interest of public safety. The content of the CNT course provides a uniform standard of practice for acupuncture needle safety in the United States. This course does not, however, replace other coursework in techniques, risk management, clinical safety or the standards of the Occupational Safety and Health Act or the Centers for Disease Control and Prevention.

Question 5: Why is it important to maintain national standards in the area of CNT?

Answer: It is essential that competency in safe needling technique by those wishing to practice acupuncture in the United States be verified to ensure the safety and health of patients, as well as practitioners and members of the public. Confidence in the safety of acupuncture by consumers, regulators, and third party payers is also a necessity in order to foster the general acceptance of acupuncture as a treatment option in the United States.

Question 6: When and where are CNT courses offered?

Answer: The CCAOM offers between 50 and 60 CNT courses annually in various cities throughout the United States, and once or twice a year in China and Korea. The courses are offered on weekends for the maximum convenience of applicants. Except for international locations, CNT courses are offered at CCAOM member colleges. The CCAOM website contains a complete list of CNT course dates ( as well as the application form for the course ( Forms for international applicants can be found at

Question 7: Can I sign up for the CNT course through my school?

Answer: The only way to register for the CNT course is by completing the application form, found on the CCAOM website (, and submitting it directly to the CCAOM national office either by fax or by mail.

Question 8: How do I know whether or not my CNT application has been accepted?

Answer: The CCAOM will confirm receipt of your application by email; therefore it is imperative that you include your email address on the application form. In addition, acceptance letters are sent out to all applicants approximately one month before the course date, also by email.

Question 9: Where can I get the Clean Needle Technique Manual?

Answer: The CCAOM has published the 7th Edition of the Clean Needle Technique Manual and has made it available on the CCAOM website as a PDF file. Anyone can download the manual free of charge from our website, in English, Chinese, or Korean. This Manual can be stored on computers or other digital devices, or it can be transferred to a flash drive and printed at a print-to-go center such as FedEx, Staples, or Kinko’s.

Question 10: Why should I study the current edition of the Clean Needle Technique Manual?

Answer: Changes in statistics and/or standards of practice necessitates the periodic publication of a new version of the manual. Also, all of the questions on the written exam are based on the content of the current edition, which has been significantly expanded from previous editions, so your ability to pass the exam is compromised if you do not have access to the most recent edition.

Question 11: Will I have to re-take the CNT course at some time in the future?

Answer: At present, the CCAOM is unaware of any state board requirement to re-take the CNT course once an applicant has successfully completed it. The NCCAOM currently requires that applicants pass the CNT course within the past six years before they actually receive NCCAOM certification. However, there is no guarantee that these agencies and boards will not change this requirement in the future.

Question 12: What is the format of the CNT written exam?

Answer: There are 50 multiple choice questions on the exam. Applicants have only one chance to pass the exam. If an applicant fails the written exam, he/she will have to re-apply for the course at a future date. (Please note that there may be up to five additional items on the exam that are being pre-tested for future use; these items will not be counted in the final grading of the exams.)

Question 13: How is the CNT written exam developed and validated?

Answer: There are two assessment components of the CNT course: a written exam and a practical exam. The written exam consists of multiple choice questions that are based on the content of the Clean Needle Technique Manual. In accordance with psychometrically sound methodology, a team of subject matter experts develops and vets the questions, and CCAOM staff tracks and evaluates responses to individual exam questions in collaboration with professional psychometricians.

Question 14: What does the CNT practical exam consist of and how is it developed?

Answer: The CNT practical exam consists of a set of verbal instructions for demonstrating proper needling technique which are provided to each applicant in advance of the course. If needed, each applicant will be given two opportunities to pass the practical exam. The protocol for this assessment is found in the Clean Needle Technique Manual and is demonstrated and coached on a group and individual basis as needed during the CNT course. The protocol for proper needling technique is researched and validated according to OSHA/CDC standards by a team of subject matter experts, and is updated as needed according to any changes in safety standards.

Question 15: What percentage of CNT applicants pass the course?

Answer: Approximately 91% of CNT participants pass the course.

Question 16: What happens if I fail the CNT course?

Answer: A failure of either the written or practical exam component results in course failure. Applicants who fail the course will have to re-pay the course fee and re-apply to take the course at a later date of their choosing.

Question 17: Do I have to take the CNT course before I take the NCCAOM exam?

Answer: The NCCAOM does not currently require applicants to take the CNT course before they sit for NCCAOM’s national exam. However, applicants cannot receive NCCAOM certification until they have documented successful completion of the CNT course.

Question 18: How do I notify the NCCAOM that I have passed the CNT course?

Answer: Applicants who are taking the CNT course for purposes of NCCAOM certification must request that the CCAOM send verification directly to the NCCAOM on their behalf by completing the appropriate form found on the CCAOM website ( and submitting it to the CCAOM national office along with a $10 payment.

Question 19: How do I notify my state licensing board that I have passed the CNT course?

Answer: A few state boards will accept a copy of the CNT certificate directly from the applicant; some require that verification come through the NCCAOM along with the rest of the applicant’s NCCAOM documentation; and yet other boards require that verification come directly from the CCAOM national office. Applicants should contact their state licensing board to find out which method of verification is required.

Question 20: When will I receive my CNT certificate of completion?

Answer: Certificates typically take from 6 to 8 weeks to arrive after course completion. However, an early certificate service is available, whereby applicants can receive their certificate within 1 to 2 weeks after course completion. Since this requires the expedited processing of an individual certificate, a written request must be submitted to the CCAOM national office along with a $10 fee.

Question 21: How long does the CCAOM maintain CNT records?

Answer: Records are permanently maintained for all individuals who have taken the CCAOM CNT course. Verification of successful completion of the course is always available upon request from the CCAOM national office.

Question 22: How do I know that my records are kept confidential?

Answer: All applications and exam-related materials are kept under lock and key on-site at the CCAOM national office. Credit card information is not kept in the database but in paper form only under lock and key, and is destroyed after a three year period of time.

Question 23: Why isn’t the CNT course offered in an on-line format?

Answer: Because of the hands-on nature of much of the course material as well as the practical testing component, the CNT course does not lend itself to on-line or distance learning modes. However, the CCAOM does offer an on-line refresher course for 4 NCCAOM PDAs that covers some aspects of safety relating to the practice of acupuncture.

Question 24: What are the scope and limitations of the CNT certificate?

Answer: The certificate provided to applicants who successfully complete the CNT course specifies that “this certificate does not constitute an authorization to practice acupuncture as such authorization is conferred only by state law.” The certificate does, however, document that the holder has demonstrated competency in the safe handling of acupuncture needles in accordance with best practices in the AOM field.

Question 25: Why are some CNT course dates cancelled, and how do I know if the course date that I have registered for will be cancelled?

Answer: In order to be able to offer the CNT course at a reasonable cost, a minimum number of applicants must be enrolled in each course. This number is generally 25, although courses may occasionally be conducted with a few less than that. If the required minimum number of applicants is not met within one month in advance of the course date, the course will be cancelled, and applicants will be notified by email at that time. Previously enrolled applicants will then be given the choice to enroll in a different class date (at no cost), or to cancel and receive a full refund.