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Medical Nutrition Therapy
Applications

These forms may be completed online, however, they cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form online, you must print the form and mail it to the address below.

Fees (if applicable) are payable to the "Licensure Unit".

Licensure Unit
Medical Nutrition Therapy
PO Box 94986
Lincoln, NE 68509-4986

pdf icon Application for Approval of a Continuing Education Program
pdf icon Application for Review of a Certificate Program Continuing Education Program
pdf icon Application for Review of a Publication Continuing Education Program
pdf icon Application for Review of a Homestudy or Video Continuing Education Program
pdf icon Duplicates/Reissue
pdf icon License Application
pdf icon Name Change Request

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