Certification Application

Please full out the application below

Please note that PAHCS membership is required to take the certification exam. If you are not yet a member of PAHCS, we invite you to learn more about the benefits of membership.

Exam Location:
Member #:
(use 0001 if unknown)
First Name:
Last Name:
Email:
Education Level:
HS Associate Bachelor Masters PhD
Experience (min. 2 years required)
At least 2 years Under 2 years *
Currently Employed as Coder:
Yes No
If Current Employer Less than 2 Years, Enter Previous Employer Contact Information
List Any Memberships to Other Professional Organizations:

Professional Reference #1:

Professional Reference #2:
Select Exam Choice:



*If you need to fax your application to PAHCS, please click here