THE AMERICAN BOARD OF PATHOLOGY
REPLACEMENT CERTIFICATE REQUEST FORM
The ABPath does not issue duplicate certificates. To request a replacement certificate to be engraved, complete and submit this form to the ABPath along with credit card authorization or check for $100.00. The replacement certificate will indicate that the certificate is a replacement and the date of the replacement. Do not check more than one certificate below. If more than one certificate needs to be replaced, a Replacement Certificate Request Form must be completed and submitted with payment for each certificate.
INSTRUCTIONS:
Please submit the full name and Last 4 digits of social security number or the Date Of Birth for each certificate request.
Requests will be completed in 5-7 business days.
Once this form is completed, please click the "Continue to the Payment page" button at the bottom to enter your payment on the next page.