Complaints Form

Any certified person or person applying to become certified has a right to file an a complaint and/or appeal for valid complaints.

First Name *

Last Name *

Phone *

Email *

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Exam Taken *

Basic ECG

12-Lead ECG

Advanced ECG

CVRN-BC Level I

CVRN-BC Level II

CVNP-BC or CVPA-BC

I attest that the information provided here is true and I am requesting a formal appeal in accordance with the ABCM's procedure on Complaints and Appeals. Provide electronic signature in the box provided. *

I Confirm

Was the exam provided online with PROV or with a live proctor?

Date of the Exam:

If this was a live site, please identify the location:

Briefly describe your complaint: *

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