Clean Needle Technique Course

Certificate/Verification Request

Please use the link below to make an online request for any of the following (after successfully completing the CNT course):

  • Replacement Certificate
  • Name Change
  • Early Certificate
  • Verification to be sent directly to board, agency, or other entity

Login is required to access the form. Before submitting your request, please log in and review the information in your profile to ensure it is current and free of errors. Multiple requests may be made through the same form.  Note that there is a separate fee for each type of request, except for name change. If you have additional questions, review the Frequently Asked Questions or contact the CCAOM office.

Request a CNT certificate, verification and/or name change.