Forms and Publications

Forms

Consumers

Document Title
Consumer Complaint Form

Applicants

Document Title
Application for Psychiatric Technician Licensure by Examination
Application for Vocational Nurse Licensure by Endorsement
Application for Vocational Nurse Licensure by Examination
Authorization for Release of Confidential Information - (55P-6)
Authorization for Release of Confidential Medical Records and Information - (55P-5)
PT Employment Verification

Licensees

Document Title
Address Change Request Form - (55P-4)
Application for Renewal
Employer Mandatory Reporting Form
Employment Verification - Nursing Experience - (55A-12)
Fee Schedule
Licensee Mandatory Reporting Form
Name Change Request Form - (55P-3)
Notice on Collection of Personal Information For Applicants and Licensees

Education

Document Title
Faculty Approval Application

Enforcement

Document Title
How To File A Complaint
Employer Mandatory Reporting
How an Arrest Affects Your License
Licensee Mandatory Reporting

Publications

Document Title
Approved School Lists
Disciplinary Action Lists
Fact Sheet (Out-of-State Applicants)
Licensed Vocational Nurse Fact Sheet
Strategic Plan