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 listed.
An Integrated Practice Agreement Application and Criminal Background Check Information Reinstatement Application Attestation of Practice Non-Practice APRN-NP Renewal Application Attestation of Supervised Practice for Practice Without Protocols Duplicates/Reissue Form Jointly Approved Protocols Name Change Form NURSYS License Verification Request Form
Professions and Occupations Home
Licensure Unit Home
