PCS Exam Request


  • Please fill out this form completely. Incomplete forms will delay processing.
  • We need a current photo to make this application complete. If you are unable to upload a current photo with this form (below), you may submit it to us by postal mail or email.
  • The $175 exam fee is non-refundable, and does not include retake exams (if needed).
  • Exam must be scheduled and taken within one month, or exam fee will be forfeited.
  • If the PCS Exam candidate does not take the exam at the scheduled exam time without at least twenty-four (24) hours advanced rescheduling of the exam, the exam fee will not be refunded, and the candidate will forfeit the exam fee, and will need to submit a new exam request and exam fee to take the exam.

Link to study material, online tutorial

Questions?

Please call Breining Institute at 916-987-2007, or contact us by email by selecting this link: Email

Section 1: PCS Exam Candidate Information
Include apartment or suite number, if applicable
Please only include the last 4 digits (numbers) of your Social Security Number. If you do not have a Social Security Number, please include the last four digits of another government identification card, and identify which government identification you are using.
We must have a current photo of the ACE Exam candidate, which will be used to verify identification of candidate at the time of the exam. You may upload it as a document with any one of the following extensions: JPG, JPEG, PNG or GIF. If you are unable to upload a photo here, please send to Breining Institute by postal mail or email attachment.
Section 2: Certification or License
Section 3. Formal Education
Section 4: Other licenses or certifications
This will assist us in awarding the highest level RAS Credential possible. Please include a copy of your license/certificate. This includes Registered Nurse (RN); Marriage and Family Therapist (MFT); Licensed Clinical Social Worker (LCSW); Medical Doctor (MD); and other similar licenses and/or certifications.
If you identified a certificate or license, above, please upload a copy of it here. You may upload it as a document with any one of the following extensions: JPG, JPEG, PNG, GIF, DOC or DOCX. If you are unable to upload the certificate or license here, please send it to us by postal mail or email.
Section 5: Credit Card and Payment Information
  • Includes examination, only.
  • Does not include retake exams (if needed).
  • Exam fee is nonrefundable.
  • Exam must be scheduled and taken within one month of submitting this exam request.
  • If the PCS Exam candidate does not take the exam at the scheduled exam time without at least twenty-four (24) hours advanced rescheduling of the exam, the exam fee will not be refunded, and the candidate will forfeit the exam fee, and will need to submit a new exam request and exam fee to take the exam.
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