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Information Booklet with
Application and Reference
Evaluation Forms
A Joint Credential for Advanced Social Work Practitioners
Advanced Certified
Hospice and Palliative
Social Worker
(ACHP-SW)
Credential Applicant Materials
Table of Contents
ADVANCED CERTIFIED HOSPICE AND PALLIATIVE SOCIAL WORKER 2
Introduction 2
Definition of Social Work in Hospice and Palliative Care 2
Benefits to holders of the ACHP-SW 3
Eligibility Requirements for Credential Applicants 3
Application Fees 4
The Application – General Directions 4
Frequently Asked Questions 5
APPLICANT INFORMATION FORM …………………………………………………………………7
Advanced Certified Hospice and Palliative - Social Worker 7
Demographic Information (Optional) 7
Candidate Attestations and Affirmation 9
Advanced Certified Hospice and Palliative - Social Worker 9
Continuing Professional Development 9
Relevant Practice Experience 9
Professional Affiliations 9
Professional Standing 9
Affirmation of NASW Standards for Palliative and End of Life Care 9
SUPERVISOR REFERENCE EVALUATION FORM 12
COLLEAGUE REFERENCE EVALUATION FORM #1 16
COLLEAGUE REFERENCE EVALUATION FORM #2 18
PAYMENT INFORMATION – Advanced Hospice and Palliative Social Worker 20
Submission Materials Checklist 20
Practice Information Codes 21
[1]
Advanced Certified Hospice and Palliative Social Worker
ACHP-SW
Introduction
Created by the National Association of Social Workers (NASW) with the support and partnership of the National
Hospice and Pallia
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