Certified Registered Central

Service Technician (CRCST) Exam

Form Valid March 1, 2023 – February 29, 2024

CRCST certification is designed to recognize entry level and existing technicians who have demonstrated the
experience, knowledge, and skills necessary to provide competent services as a sterile processing technician.
CRCST’s are integral members of the healthcare team who are responsible for decontaminating, inspecting,
assembling, disassembling, packaging, and sterilizing reusable surgical instruments or devices in a health
care facility which are essential for patient safety.

To earn CRCST certification, candidates are required to successfully demonstrate skills through the
completion of hands-on work experience in a Central Service/Sterile Processing department, as well as
the successful completion of an examination developed to measure the understanding of general sterile
processing and infection prevention topics. Those certified as a CRCST are required to renew their credentials
annually through the completion of continuing education requirements.

Please read and complete each section fully and accurately in clear, legible handwriting or type. The
completed application and full payment must be received for processing.

Submitted applications will be processed in approximately three to four weeks. By submitting, you agree to
a $25 non-refundable processing fee. Information on how to schedule your exam, as well as your window of
eligibility, will be sent to the email provided. (Scheduling information cannot be provided by phone.) Once
your application is approved, it is your responsibility to schedule your exam within the 120-day window provided.

Additional information on certification requirements, policies, and procedures is available in the HSPA
Handbook and at myhspa.org/certification. For further assistance, contact HSPA at 312.440.0078 or
certification@myhspa.org.

Please complete each page and mail, fax, or email your completed application to:

Mail: HSPA Fax: 312.440.9474

55 West Wacker Drive, Suite 501 Email: certification@myhspa.org
Chicago, IL 60601

APPLICATION CHECKLIST S
 ection 3: Standards of Conduct, Disclosure,
and Attestations
I am ready to sit for the CRCST exam within I have signed and dated the Statement
the next 4 months, once my application is of Understanding.
approved.
S
 ection 4: Application Fee
S
 ection 1: Certification Type I have included a signed check/money order or
Select full or provisional. credit card information with the application.

S
 ection 2: Applicant Information S
 ection 5: Hands-On Experience
I have completed the applicant information. My Manager/Supervisor has completed and
signed the Hands-On Experience. Please
complete ONLY if applying for Full Certification.

HSPA complies with the Americans with Disabilities Act (ADA) and is interested in ensuring that no disabled individual is
deprived of the opportunity to take an examination solely by reason of that disability. HSPA will arrange to provide special
testing accommodations for those individuals with a condition or disability as defined under the ADA. Accommodations
will be provided at a designated testing center at no additional cost to the applicant.

HSPA’s “Americans with Disabilities Policy Statement” can be found in full at myhspa.org and in the Certification
Handbook. If you believe that you qualify for an accommodation pursuant to the ADA, we ask that you contact HSPA to
request a Special Accommodations form, to be completed and submitted with your application.

PAGE 1 OF 4 MYHSPA.ORG/CERTIFICATION
Certified Registered Central
Service Technician (CRCST) Exam
Form Valid March 1, 2023 – February 29, 2024

SECTION 1: CERTIFICATION TYPE

Please let us know if you are applying for Full Certification or Provisional Certification.

F
 ull Certification: I have completed the required 400 hours of hands-on experience, as outlined by Section 5
of this application, in a Central Service/Sterile Processing department. My Manager/Supervisor has completed
Section 5 and I am submitting it with my application to test.

P
 rovisional Certification: I will complete the required 400 hours of hands-on experience within 6 months of
passing the certification exam. My hours will be accumulated in the categories, as outlined by Section 5 of this
application. I understand that if I fail to complete and submit documentation of these hours to HSPA prior to the
deadline, my certification will be revoked and I will be required to re-apply for certification.

SECTION 2: APPLICANT INFORMATION

Please enter your first and last name as they appear on your primary government issued photo ID.

Mr. Mrs. Ms. Dr.

Applicant First Name:___________________________________________________________________________________________________

Applicant Last Name(s):_________________________________________________________________________________________________

HSPA ID# (Optional):____________________________________________________________________________________________________

Personal Information

Home Address: __________________________________________________________________ Apt/Floor/Unit: ______________________

City, State/Province, Zip/Postal Code:_____________________________________________________________________________________

Country (if outside the USA):_____________________________________________________________________________________________

Home Telephone: __________________________________________ Personal Email: ____________________________________________

Employment Information (if available)

Organization Name:_____________________________________________________________________________________________________

Current Position Title:___________________________________________________________________________________________________

Business City and State/Province:________________________________________________________________________________________

Country (if outside the USA):_____________________________________________________________________________________________

Business Telephone: _______________________________________ Business Email: ____________________________________________

An email is required. Confirmation and scheduling information will be sent by email. Please check which email you would
like to be used for correspondence: personal business

Please check which address you would like to be used for any mailed correspondence: personal business

PAGE 2 OF 4 MYHSPA.ORG/CERTIFICATION
Certified Registered Central
Service Technician (CRCST) Exam
Form Valid March 1, 2023 – February 29, 2024

SECTION 3: STANDARDS OF CONDUCT, DISCLOSURE AND ATTESTATIONS

APPLICATION STATEMENT OF UNDERSTANDING
I hereby apply to take the CRCST exam. By signing below and submitting an exam application and fee, I attest that I have read and
understand the HSPA Certification Handbook (available online at myhspa.org) and agree to abide by the certification program’s policies
and procedures, and adhere to the Association’s code of conduct. I agree to inform HSPA, without delay, of any matter that affects my
ability to fulfill the certification requirements.

I further certify that the information provided by and about me on this form (and any other subsequent documentation submitted in
relation to my certification) is accurate and correct. I understand that the information I provide to HSPA may be audited for verification.
I agree to provide any information necessary to verify my experience and authorize HSPA to make any necessary inquiries in this
regard. I understand that providing information on this or any document relating to my certification which is determined to be false
or purposefully misleading, or in violation of any portion of the Code of Conduct and/or other policies and procedures, may result in
disciplinary action, including the possible denial or revocation of certification, as outlined in the disciplinary policy.

Release of Exam Results

I understand that I will receive an individual score report containing a notification of “pass” or “fail” for the overall examination on screen
at the testing center upon completion of the exam, and that HSPA will only release my pass/fail results directly to me, in written format,
at the preferred address provided herein. Result reports containing an indication of my performance in each of the content domains
are not available orally or electronically, and can take up to two weeks to be delivered. Pass/fail notifications will not be provided to 3rd
parties without my prior express written consent. Upon request, HSPA will verify an individuals’ current certification status (including
their certification effective and expiration dates) to any inquiring party, but will not release the details of an individual’s examination(s),
including exam scores and the number of exam attempts.

Use of Personal Information

The information provided to HSPA on this form, and in regard to my certification exam, will be used in accordance with HSPA’s
Confidentiality Policy, included in the Certification Handbook and available online at myhspa.org. If I request and am granted special
testing accommodations, HSPA may disclose personal information to third parties as necessary to administer my examination. This
may include such information as my disability status, medical condition, or any political, religious, or philosophical beliefs which require
accommodation. If HSPA is required by law to disclose confidential information, the individual(s) whose information is released will be
notified to the extent permitted by law.

Non-Disclosure Agreement
This examination is confidential and proprietary. It is made available to me, the examinee, solely for the purpose of becoming certified
in the technical area referenced in the title of this exam. I am expressly prohibited from recording, copying, reproducing, disclosing,
publishing, or transmitting this examination, in whole or in part, in any form or by any means, verbal or written, electronic or mechanical,
for any purpose.

Printed Name:__________________________________________________________________________________________________________

Signature (must be handwritten): ______________________________________________________________________________________

Date:___________________________________________________________________________________________________________________

SECTION 4: APPLICATION FEE IS $140 USD

Payment must be submitted with the application for processing. We cannot accept purchase orders or payments by
phone. The application fee includes the cost to take the exam one time, as well as a $25 non-refundable processing fee.
Subsequent examinations and testing are subject to additional testing fees.

Check or Money Order enclosed (payable to HSPA) VISA MasterCard American Express Discover

Cardholder Name:______________________________________________________________________________________________________

Credit Card Number:____________________________________________________________________________________________________

CVV (found on back of card):_____________________________________________________________________________________________

Expiration Date:_________________________________________________________________________________________________________

Zip Code of Billing Address:______________________________________________________________________________________________

Signature (must be handwritten): ______________________________________________________________________________________

PAGE 3 OF 4 MYHSPA.ORG/CERTIFICATION
Certified Registered Central
Service Technician (CRCST) Exam
Form Valid March 1, 2023 – February 29, 2024

TO BE COMPLETED IN FULL BY YOUR MANAGER/SUPERVISOR

SECTION 5: HANDS-ON EXPERIENCE

All information on this page must be completed in full by the Manager/Supervisor who oversaw the applicant’s work/volunteer
experience. If the applicant completes any portion of this page, the application will be rejected.
• The information must be verified by a person in a position higher than the applicant (Lead Tech, Coordinator,
Supervisor, Manager, Director, Chief, Administrator or Hospital-Based Educator/Trainer).
• Each of the six areas below are mandatory for completion, and the hours must be completed in full, in a Central
Service/Sterile Processing department.
• If the applicant completed their experience in more than one facility, additional copies of this page
must be completed by each Manager/Supervisor, indicating the specific number of hours completed in each area.
• Manager/Supervisor must provide work contact information. No personal contact information will be accepted.

PLEASE INITIAL EACH AREA OF EXPERIENCE COMPLETED BELOW (Typed Initials will Not Be Accepted):

________ 1. Decontamination (120 Hours)

INITIAL Blood-Borne Pathogens, Soiled Item Transport, Safety (e.g. Chemical Handling, Sharps), Manual Instrument Cleaning,
Mechanical Cleaning (e.g. Washers, Ultrasonic Cleaners), Decontamination Area Disinfection Processes, Interpreting
Manufacturer’s IFUs (e.g. Device Cleaning, Equipment Operation, Chemical, Enzymatics/Detergents, Current Measurements/
Concentration, Soak Time), Item Receiving & Traceability
________ 2. Preparing & Packaging Instruments (120 Hours)
INITIAL Identification, Inspection/Testing of Instruments, Inspection/Testing of Containers & Wrapping Material, Assembly, Packaging
Techniques (e.g. Pouches, Flat Wraps, Rigid Containers), Labeling
________ 3. Sterilization & Disinfection (96 Hours)
INITIAL High Temperature Sterilization Processes, Low Temperature Sterilization Processes, Logging & Record Keeping (e.g.
Sterilization/HLD, Biologicals/Incubation), Handling & Putting Away of Sterile Supplies, Automated/Manual Disinfection,
Trouble Shooting (e.g. Aborted/Failed Cycles, Wet Loads, Repairs)
________ 4. Storage & Distribution (24 Hours)
INITIAL Clean & Sterile, Handling & Putting Away of Sterile Supplies, Rotating Supplies, Inventory & Restocking Carts/Shelves (e.g.
Inventory Systems, Par Levels), Event Related Shelf Life/Expiration Dating, Cleaning Storage Shelves, Case Carts (e.g. Assembly,
Pick Lists & Locator Systems)
________ 5. Quality Assurance Processes (24 Hours)
INITIAL Interpreting Manufacturer’s IFUs (e.g. Device Inspection & Testing, Sterilizers), Standards, Regulations, Policies & Procedures,
Documentation & Record Keeping (e.g. Management, Area Cleaning), Quality/Functionality Testing Processes (e.g. Sterilizer,
Washer Testing, HLD)
________ 6. Equipment (16 Hours)
INITIAL Cleaning, Inspection and/or Preparation of Patient Care Equipment, Equipment Functionality Check (e.g. Autoclaves,
Sterilizers, Washers), Familiarity with Routine Maintenance Guides for Equipment, Equipment Tracking
Printed Name of Applicant: _____________________________________________________________________________________________

Dates of Experience (must have occurred within the past 5 years):

from (month/date/year) ___________ /___________ /___________ to (month/date/year) ___________ /___________ /___________

Name of Facility Where Experience Was Obtained:_______________________________________________________________________

Facility Address: ________________________________________________________________________________________________________

City, State/Province, Zip/Postal Code:_____________________________________________________________________________________

Is the Applicant a Current Employee of the Facility: Yes No

Printed Name of Manager/Supervisor:___________________________________________________________________________________

Current Position of Manager/Supervisor:_________________________________________________________________________________

Select one: Lead Tech Coordinator Supervisor Manager Director Chief Administrator Other_________
DESCRIBE

Work Phone (with extension): ___________________________________ Work Email: ___________________________________________

I attest that the applicant listed above has completed the minimum 400 hours of hands-on experience required for the Certified Registered
Central Service Technician (CRCST) certification. I further understand that I may be called upon to verify this information in further detail.

Signature (must be handwritten):___________________________________________________________Date: ______________________

PAGE 4 OF 4 MYHSPA.ORG/CERTIFICATION