CGFNS is the organisation that checks the credentials of nurses educated outside the United States. In 2025 it changed its name to TruMerit, so you will see both names on forms, job ads and the CGFNS Connect portal. For nurses it runs three main services: VisaScreen, the federal screening you need before a US occupational visa or green card; the Credentials Evaluation Service (CES), a report that compares your education with US standards for state boards of nursing; and the Certification Program, which includes the Nurse Qualifying Exam. VisaScreen costs USD 740 and the CES Professional Report USD 485. Once all your documents have arrived, most reports are issued within days, but getting the documents from your school and regulator takes about 14 weeks on average.
This guide explains each service, who needs it, what it costs and how long it takes. We checked TruMerit’s pages on 16 October 2026. Fees and requirements change, so check TruMerit’s own pages before you pay. This is general information, not legal or immigration advice.
CGFNS full form and the new name
CGFNS stands for Commission on Graduates of Foreign Nursing Schools. Founded in 1977, it later traded as CGFNS International. Its page on the new name says the rollout of TruMerit happened “over the first half of 2025”, because the old name “no longer fits us”: the organisation now serves many health professions, not only nurses (TruMerit new name).
The old website, cgfns.org, now says “CGFNS is now TruMerit” and is kept only as a redirect (cgfns.org). The service names VisaScreen and CES have not changed, although TruMerit says it is exploring revisions to both.
CGFNS Connect: login and account
All applications start in the online portal. TruMerit tells applicants to set up a free account on CGFNS Connect first, then apply through the TruMerit Connect portal (TruMerit VisaScreen). Use one account for every service, and your name exactly as it appears on your passport. If you ever ordered a CGFNS report before, log in to the same account rather than creating a new one, so your documents can be reused.
The three services compared
| Service | What it is for | Who usually asks for it | Fee |
|---|---|---|---|
| VisaScreen | Federal health care worker screening for a US work visa or green card | US immigration (consulate or USCIS) | USD 740 |
| CES Professional Report | Comparison of your nursing education and licences with US standards | State boards of nursing, employers, immigration lawyers | USD 485 |
| Certification Program | Credentials review, the Nurse Qualifying Exam and an English test | About two thirds of state boards, before the NCLEX-RN | USD 495 |
Fees are from TruMerit’s fee schedule (TruMerit fees). Which you need depends on the state where you will be licensed and on your visa route. Many nurses need both a state-board report (CES or Certification Program) and VisaScreen.
VisaScreen
What is a VisaScreen?
VisaScreen is TruMerit’s “comprehensive screening service for healthcare professionals seeking an occupational visa to work in the United States” (TruMerit VisaScreen). Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 requires certain health care workers to complete a screening before they get a permanent or temporary occupational visa. If you pass, you receive the ICHP certificate.
The federal regulation that puts this into effect, 8 CFR 212.15, lists the occupations covered. They include registered nurses, licensed practical nurses and licensed vocational nurses, and it names CGFNS as an organisation authorised to issue nurse certificates (8 CFR 212.15).
What VisaScreen checks
- Education: that your nursing education is comparable to a US graduate’s.
- Licences: that every licence you have ever held is valid and unrestricted. Licence validations must be signed within the last three years.
- English: a pass on an approved test. TruMerit accepts Cambridge English (B2 First, C1 Advanced, C2 Proficiency), TOEFL iBT, IELTS Academic, the Michigan English Test, OET and PTE Academic. At-home versions are not accepted.
- Nursing knowledge (RNs only): a pass in the NCLEX-RN or TruMerit’s Nurse Qualifying Exam (NQE).
New English score requirements set by the US Health Resources and Services Administration (HRSA) apply to tests taken on or after 12 May 2026. Tests taken before then are judged under the previous scores, and TruMerit no longer accepts TOEIC (TruMerit English update). Our US nursing jobs guide lists the registered nurse scores, and our OET or IELTS guide helps you choose a test.
You may be exempt from the English test if you trained in Australia, Canada (except Quebec), Ireland, New Zealand, the United Kingdom or the United States, as 8 CFR 212.15 sets out.
VisaScreen fee, expedite and renewal
| Item | Fee |
|---|---|
| VisaScreen application, including the certificate | USD 740 |
| Expedited review | USD 650 extra |
| Renewal application | USD 475 |
VisaScreen expiration and renewal
Under 8 CFR 212.15, the certificate must be used within 5 years of the date it is issued. If your visa or green card process runs longer, you renew. For renewal only, TruMerit can waive the English test if you have at least 27 months of US work in the profession, including 9 months before the renewal order date, shown by a letter from your US employer.
VisaScreen processing time
TruMerit publishes average times (TruMerit processing times):
| Service | Processing time after all documents are received and validated |
|---|---|
| VisaScreen | 90% of certificates issued within 3.5 business days; half of those on the same day |
| CES | 70% of reports issued within 7 business days |
The key phrase is after all documents are received. TruMerit does not start until your school, regulator and test provider have sent their documents directly to it, and it says document collection averages 14 weeks. Delays or rejected documents make it longer. So in practice, plan for three to four months from ordering to certificate, and more if your school is slow.
How to shorten the wait:
- Order early, before you need the result.
- Contact your nursing school and licensing board as soon as you apply, and ask how they send verifications to TruMerit.
- Ask your English test provider to send your score to TruMerit when you book the test. TruMerit lists a separate USD 25 fee for forwarding English test results.
- Make sure every name on every document matches, or include proof of the change.
CGFNS Credentials Evaluation Service (CES)
The CES Professional Report “provides a detailed analysis of nursing credentials earned outside the United States”, including a statement of how your nursing education compares with US standards. TruMerit says its reports are accepted by all 50 state boards of nursing, and that they are also used by employers and immigration lawyers (CES Professional Report).
What you need:
- a diploma or certificate showing your highest secondary education
- your licences, registrations and nursing diploma, sent directly to TruMerit by the issuing authority
- the complete transcript from every nursing programme you attended
- documents in English, or TruMerit’s translation at USD 85 a page
| CES item | Fee |
|---|---|
| CES Professional Report | USD 485 |
| Expedited review | USD 425 |
| Re-evaluation | USD 295 |
| Extra report recipients | USD 175 each |
There is also a CES Academic Report at the same price, for academic purposes. Check with your state board which report it wants before you order.
The Certification Program and the Nurse Qualifying Exam
The Certification Program (formerly the CGFNS Certification Program) is for first-level, general nurses educated outside the US. It has three parts: a credentials review, the TruMerit Nurse Qualifying Exam (NQE), and an English test with both spoken and written English. TruMerit says about two thirds of state boards of nursing require it before they approve you for the NCLEX-RN, and that passing the NQE also meets VisaScreen’s nursing knowledge requirement (Certification Program).
The NQE runs at Kryterion test centres worldwide. You schedule after you receive an Authorization to Test, and your English score must be from a test taken within one year of your NQE date. The application costs USD 495.
If you plan to sit the NCLEX anyway, read our NCLEX-RN guide for international nurses to see which route suits you.
CGFNS for New Zealand
TruMerit is not only for the US. The Nursing Council of New Zealand tells internationally qualified nurses: “You must first verify your documents with TruMerit before applying to the Council to register.” You cannot apply to the Council directly, and the Council’s processing time does not include the time TruMerit takes (Nursing Council of New Zealand). So if you are heading to New Zealand, your first step is a TruMerit order, not a Council application.
Where this fits in your job search
For the US, the order is usually: state board route (CES or Certification Program, then the NCLEX-RN), then an employer offer, then the green card petition with VisaScreen. Our US nursing jobs guide explains the EB-3 Schedule A route.
On the board, see US nursing jobs, New Zealand nursing jobs and jobs with visa sponsorship. Never pay an agent to “process” your VisaScreen; you apply and pay TruMerit directly. See our guide to ethical recruitment and scams.
Frequently asked questions
What is the CGFNS full form?
CGFNS stands for Commission on Graduates of Foreign Nursing Schools. The organisation changed its name to TruMerit during the first half of 2025, but it still uses the CGFNS Connect portal and the VisaScreen and CES service names.
How much does VisaScreen cost?
TruMerit’s fee schedule lists the VisaScreen application, including the certificate, at USD 740. Expedited review costs USD 650 more, and a renewal application costs USD 475.
How long does VisaScreen take?
TruMerit says 90% of VisaScreen certificates are issued within 3.5 business days once all primary source documents have been received and validated. Collecting those documents from schools and regulators averages 14 weeks, so the total is usually several months.
How long is a VisaScreen certificate valid?
Under 8 CFR 212.15, the certificate must be used within 5 years of the date it is issued. After that, you need a renewal, which costs USD 475.
What is the difference between VisaScreen and the CGFNS credentials evaluation?
VisaScreen is for US immigration: it is the federal screening for an occupational visa or green card. The Credentials Evaluation Service (CES) report is for licensing: state boards of nursing and employers use it to judge your education against US standards.
Is the CGFNS exam the same as the NCLEX?
No. TruMerit’s Nurse Qualifying Exam (NQE) is part of its Certification Program and meets VisaScreen’s nursing knowledge requirement. The NCLEX-RN is the US licensing exam. VisaScreen accepts either a pass in the NQE or the NCLEX-RN.