ALNCCB & LNCC Program Item Writer Questionnaire 2026

Thank you for your interest in volunteering as an LNCC program Item Writer. The information collected in the following questionnaire will assist the American Legal Nurse Consultant Certification Board (ALNCCB) to know what topics/issues you are interested in as well as your areas of skill and expertise. Please complete the following areas appropriately.

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* 1. Name

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* 2. Email

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* 3. Phone Number

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* 4. Address

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* 5. Employer Name

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* 6. Current Position

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* 7. Number of years as a Registered Nurse

0-2 years

3-5 years

6-10 years

11-15 years

16 years +

Retired

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* 8. Are you certified as an LNCC?

Yes

LNCC-Retired

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* 9. List any additional certifications you hold.

Certification 1

Certification 2

Certification 3

Certification 4

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* 10. Have you served as an ALNCCB Item Writer in the past?

Yes

Other (please specify)

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* 11. Have you served as a volunteer for ALNCCB in the past?

Yes

Other (please specify)

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* 12. Please indicate the highest level of nursing education you have completed:

Diploma

Associate Degree

Baccalaureate Degree

Master's Degree

Doctorate

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* 13. Indicate your areas of subject matter expertise as a Legal Nurse Consultant and number of years experience in these areas:

	< 5 years	> 5 years
Medical malpractice	Medical malpractice < 5 years	Medical malpractice > 5 years
Personal injury	Personal injury < 5 years	Personal injury > 5 years
Product liability	Product liability < 5 years	Product liability > 5 years
Long term care litigation	Long term care litigation < 5 years	Long term care litigation > 5 years
Workers' Compensation	Workers' Compensation < 5 years	Workers' Compensation > 5 years
Risk management	Risk management < 5 years	Risk management > 5 years
Life Care planning	Life Care planning < 5 years	Life Care planning > 5 years
Toxic Tort	Toxic Tort < 5 years	Toxic Tort > 5 years
Regulatory compliance	Regulatory compliance < 5 years	Regulatory compliance > 5 years
Medicare set-aside	Medicare set-aside < 5 years	Medicare set-aside > 5 years

Other (please specify)

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* 14. Please provide a brief statement describing your leadership experience and areas of professional expertise which contribute to your qualifications for this volunteer position: