The Arizona Community Health Workers Association and the Arizona Department of Health Services are partnering and supporting CHWs with the CHW Voluntary Certification fees

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First and Last Name
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Please enter your email. *

What is your job title/position?
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Are you a CHW/CHR/Promotor(a)?
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CHW

CHR

Promotor(a)

No, I am not a CHW/CHR/Promotor(a)

If yes, for how long have you been a CHW/CHR/Promotor(a)?
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1-5 Years

5-10 Years

10+ Years

No, I am not a CHW/CHR/Promotor(a)

Enter the name of your organization. *

Please enter you supervisor contact information (Name, email, phone number, etc). *

Which of the following best describes the type of your organization?
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Community Based Organization

Health Clinic/Hospital

Community Health Center

Government Agency

Other:

Please enter your work zip code.
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Please select your ethnicity.
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White

Hispanic or Latino

Black or African American

Native American or Alaskan Native

Asian

Other:

Required

When do you plan to apply for ADHS CHW Voluntary Certification?
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I hereby acknowledge that I am a Community Health Worker working within Yuma County.
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Yes

Required

Which of the 4 Pathways for Certification will you choose?

Pathway #1: 960 hours of paid or volunteer experience providing CHR or CHW services in the core competencies, during the previous three-year time-period.

Pathway #2: Completion of a CHW certificate program, including core competencies, provided by an accredited college, and 480 hours of paid or volunteer CHR or CHW experience completed during the previous three years.

Pathway #3: Completion of a CHW training program provided by an organization or certified CHW trainer, including core competencies and 480 hours of paid or volunteer CHR or CHW experience completed during the previous three years.

Pathway #4: Completion of a CHR National Training Program (provided by IHS). This is basic training certification and 480 hours of paid or volunteer CHR or CHW experience completed during the previous three years OR Advanced training certification and 380 hours of paid or volunteer CHR or CHW experience completed during the previous three years

Clear selection

Thank you for submitting your application!

For any questions, comments or concerns please contact Richard Redondo at richard@azchow.org or Francisco Oros at francisco@azchow.org.

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