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NMC Revalidation Confirmation Form

This document is a form for nurses or midwives to record confirmation of meeting revalidation requirements from a confirmer such as a line manager. It lists requirements like practicing minimum hours, completing continuing professional development activities, obtaining practice-related feedback, and creating reflective accounts. The confirmer verifies reviewing evidence that the nurse or midwife has met all revalidation requirements over the past three years and signs to confirm compliance.

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Gianina Avasiloaie
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142 views3 pages

NMC Revalidation Confirmation Form

This document is a form for nurses or midwives to record confirmation of meeting revalidation requirements from a confirmer such as a line manager. It lists requirements like practicing minimum hours, completing continuing professional development activities, obtaining practice-related feedback, and creating reflective accounts. The confirmer verifies reviewing evidence that the nurse or midwife has met all revalidation requirements over the past three years and signs to confirm compliance.

Uploaded by

Gianina Avasiloaie
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
  • Confirmation Form
  • Revalidation Requirements Checklist
  • Practice-related Feedback and Reflective Accounts

You must use this form to record your confirmation.

To be completed by the nurse or midwife:


DANIELA- GIANINA AVASILOAIE
Name:
12H0147C
NMC Pin:
31.08.2017
Date of last renewal of registration or
joined the register:

I have received confirmation from (select applicable):

A line manager who is also an NMC-registered nurse or midwife

A line manager who is not an NMC-registered nurse or midwife

Another NMC-registered nurse or midwife

A regulated healthcare professional

An overseas regulated healthcare professional

Other professional in accordance with the NMC’s online confirmation tool

To be completed by the confirmer:

Name:

Title:

Email address:

Professional address
including postcode:

Contact number:

Date of confirmation discussion:


If you are an NMC-registered nurse or midwife please provide:

NMC Pin:

If you are a regulated healthcare professional please provide:

Profession:

Registration number for regulatory body:

If you are an overseas regulated healthcare professional please provide:

Country of practice:

Profession:

Registration number for regulatory body:

If you are another professional please provide:

Name of regulating body:

Registration number for regulatory body:

Confirmation checklist of
revalidation requirements
Practice hours

You have seen written evidence that satisfies you that the nurse or midwife has
practised the minimum number of hours required for their registration.

Continuing professional development


You have seen written evidence that satisfies you that the nurse or midwife has
undertaken 35 hours of CPD relevant to their practice as a nurse or midwife.

You have seen evidence that at least 20 of the 35 hours include participatory learning
relevant to their practice as a nurse or midwife.

You have seen accurate records of the CPD undertaken.


Practice-related feedback

You are satisfied that the nurse or midwife has obtained five pieces of
practice-related feedback.

Written reflective accounts


You have seen five written reflective accounts on the nurse or midwife’s CPD and/or
practice-related feedback and/or an event or experience in their practice and how this
relates to the Code, recorded on the NMC form.

Reflective discussion

You have seen a completed and signed form showing that the nurse or midwife has
discussed their reflective accounts with another NMC-registered nurse or midwife (or
you are an NMC-registered nurse or midwife who has discussed these with the nurse or
midwife yourself).

I confirm that I have read Information for confirmers, and that the above named NMC-
registered nurse or midwife has demonstrated to me that they have complied with all
of the NMC revalidation requirements listed above over the three years since their
registration was last renewed or they joined the register as set out in Information for
confirmers.

I agree to be contacted by the NMC to provide further information if necessary for


verification purposes. I am aware that if I do not respond to a request for verification
information I may put the nurse or midwife’s revalidation application at risk.

Signature:

Date:

You must use this form to record your confirmation. To be completed by the nurse or midwife: Name: DANIELA- GIANINA AVASILOA
If you are an NMC-registered nurse or midwife please provide: NMC Pin: If you are a regulated healthcare professional please
Practice-related feedback You are satisfied that the nurse or midwife has obtained five pieces of practice-related feedback.

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