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.
Application for Reinstatement to practice an asbestos occupation is required if your license has been revoked, expired, placed on inactive status, lapsed or voluntarily surrendered without disciplinary action. Reinstatement fees are included in the application.
Fees (if applicable) are payable to the "Public Health Licensure Unit".
Department of Health & Human Services
Public Health Licensure Unit
PO Box 94986
Lincoln, NE 68509-4986
Initial Application for Asbestos Occupation Certification and Limited Certification
Reinstatement Application for Asbestos Occupation Certification and Limited Certification
Name Change Form