CGFNS International (TruMerit): Certification and Exams

• TruMerit keeps no professional register. It issues reports and certificates.
• VisaScreen: Visa Credentials Assessment, the federal health care worker certificate for nine occupations, including RNs and LPN/VNs.
• Credentials Evaluation Service (CES) Professional Report, a comparability report on nursing education and licenses used by state boards, employers and immigration attorneys.
• TruMerit (CGFNS) Certification Program: credentials review, the Nurse Qualifying Exam and English, which TruMerit says about two-thirds of state boards require before the NCLEX-RN.
• Credentials Verification Service (CVS) for New York State, for RNs, LPNs, physical therapists and occupational therapists and their assistants applying in New York.
• The 212(r) Certified Statement, an alternative to VisaScreen for some RNs who already hold a license in certain states.

• VisaScreen education check: your professional education must be comparable to US graduates in the same profession.
• VisaScreen license check: all current and past professional licenses from every jurisdiction must be validated.
• VisaScreen English: passing scores on an approved test (no at-home versions), unless your entry-level professional education was in the UK, Australia, Canada (except Quebec), New Zealand, Ireland or the US and taught in English with English textbooks.
• VisaScreen for RNs only: proof that you passed the TruMerit Nurse Qualifying Exam (through the Certification Program) or the NCLEX-RN, verified by a US state board of nursing.
• CES Professional Report: secondary school diploma or exam certificates, nursing transcripts sent by your school, and licenses and registrations sent directly by the issuing authorities.
• CES license validations must have issuing authority signatures dated within three years; some states require nine months.
• 212(r) Certified Statement: an active RN license in Florida, Georgia, Illinois, Michigan or New York, an NCLEX-RN pass, and nursing education in English in one of the listed countries (Australia, Barbados, certain Quebec schools in Canada, Ireland, Jamaica, New Zealand, South Africa, Trinidad and Tobago, the UK or the US).

Check your route with the route finder

1. 1

   Work out which TruMerit services you need

   Check your state board's requirements first: it may want a CES Professional Report, the Certification Program, or (in New York) the CVS. Then check whether your visa route needs VisaScreen; most nurses immigrating on an employer petition do. Ordering the wrong service is a costly and common mistake, since fees are not interchangeable.
2. 2

   Create a TruMerit Connect account and order

   Apply online and pay the fee for each service. Enter your name exactly as on your passport and list every license you have ever held, including expired ones. TruMerit asks why you need VisaScreen for research only; it does not advise on visas and suggests asking an attorney.
3. 3

   Have documents sent directly

   Your nursing school sends transcripts and your licensing authorities send license validations directly to TruMerit, using TruMerit's request forms. Documents from you are not accepted as primary source. Delays usually come from schools or regulators that are slow to respond, so contact them early.
4. 4

   Send English scores

   Ask the testing agency to send your scores to TruMerit. For the CES, scores must be less than two years old. Pick a test and score that satisfy both your state board and VisaScreen so you only test once.
5. 5

   Pass the NCLEX-RN or the Nurse Qualifying Exam (RNs, for VisaScreen)

   VisaScreen for RNs needs verification from a state board that you passed the NCLEX-RN, or a pass in the TruMerit Nurse Qualifying Exam through the Certification Program. Most nurses use their NCLEX pass. The Qualifying Exam is taken at Kryterion test centers after you receive an authorization-to-test email.
6. 6

   Receive your report or certificate

   TruMerit issues certificates digitally; a paper VisaScreen certificate costs extra. Your CES report goes to the board you chose, and extra recipients cost more. The VisaScreen certificate is presented in your visa or adjustment of status process.
7. 7

   Renew VisaScreen if needed

   A VisaScreen certificate is valid for five years from issue. Order the renewal within six months of expiry; if you miss that window you must pay for a full new application. Renewal needs updated license validations and English evidence, unless you have at least 27 months of US employment in the profession.

• TruMerit Nurse Qualifying Exam (NQE)

  Part of the TruMerit Certification Program. TruMerit describes it as a global competency exam that measures the entry-to-practice knowledge, skills and behaviors of first-level general nurses. It is delivered through Kryterion's global test center network after you receive an authorization to test. TruMerit's page does not publish the question count; check the Certification Program handbook.

• NCLEX-RN (accepted for VisaScreen)

  VisaScreen accepts an NCLEX-RN pass verified by a US state board instead of the Qualifying Exam. The NCLEX is run by NCSBN and delivered by Pearson VUE; see the NCSBN page for its format and fees.

  Read the guide

• English proficiency tests

  TruMerit accepts Cambridge English (B2 First, C1 Advanced or C2 Proficiency), TOEFL iBT, Academic IELTS, the Michigan English Test, OET and PTE Academic. At-home versions are not accepted.

• Scores for registered nurses and other bachelor's-level health care workers (TruMerit table effective May 12, 2026):
• IELTS: 6.5 overall with 7 in speaking.
• OET: 360 in speaking, 340 in reading, 350 in writing and 320 in listening.
• TOEFL iBT: 4.5 overall, 4.5 in speaking and 3.5 in reading, listening and writing (the 2026 TOEFL score scale).
• PTE Academic: 55 overall, 76 in speaking and 62 in reading, writing and listening. MET: 58 overall, 59 speaking. Cambridge English: 169 overall, 194 speaking.
• LPN/VNs and other health care workers below bachelor's level have lower thresholds, for example IELTS 6 overall with 7 in speaking.
• If you took your test before May 12, 2026, TruMerit assesses you against its previous score requirements.
• Exemption: entry-level professional education in the UK, Australia, Canada (except Quebec), New Zealand, Ireland or the US, with English as the language of instruction and textbooks.

Estimate your total cost

• Most of the time goes on getting your school and regulators to send documents; TruMerit's clock effectively starts once primary-source documents are received and validated.
• VisaScreen: TruMerit says 90% of certificates are issued within 3.5 business days of documents being received and validated, and 50% of those the same day.
• CES Professional Report: TruMerit says 70% of reports are issued within 7 business days once primary-source documents are validated.
• CVS New York: 80% of reports within seven business days once documents are received; you have up to 12 months from ordering to complete it.
• VisaScreen certificates last five years; renew within six months of expiry.