Business Goal of Enhancing Public Safety
|
|
- Stephen Smith
- 8 years ago
- Views:
Transcription
1 Business Goal of Enhancing Public Safety BOARD OF REGISTERED NURSING JANETTE WACKERLY, MBA, RN SUPERVISING NURSING EDUCATION CONSULTANT
2 Board of Registered Nursing 1747 North Market Blvd., # 150 Sacramento, CA
3 L.A Times Articles: When Caregivers Harm: Problem Nurses Stay on Job s Patients Suffer Reform of California Nursing Board s Discipline System Shows Early Progress State Board Seeks Swifter Action Against Errant Nurses Loose Reins on Nurses in Drug Abuse Program Charles Orenstein and Tracy Webb
4 Mission Statement Protection of the public shall be the highest priority for the Board of Registered Nursing in exercising its licensing, regulatory, and disciplinary functions. Whenever the protection of the public is inconsistent with other interests sought to be promoted, the protection of the pubic shall be paramount.
5 The BRN Oversees As of March 2012 RN 386,545 CNS 3,124 CRNA 2,094 CNM 1,220 NP 16,641 PHN 52,513 RN Psych/Mental Health listings 386 Continuing Education Providers 3,437
6 Licensing Program Applications Licenses/Certs Registered Nurses Received Examination 27,227 Endorsement 9,496 Licenses 22,948 Issued Certificates 5,045
7 Board of Registered Nursing APPLICANTS AND LICENSEES WITH ENFORCEMENT ISSUES
8 Application for Licensure by Examination
9 Have You Ever? HAVE YOU EVER HAD DISCIPLINARY PROCEEDINGS AGAINST ANY LICENSE AS A RN OR ANY HEALTH-CARE RELATED LICENSE OR CERTIFICATE INCLUDING REVOCATION, SUSPENSION, PROBATION, VOLUNTARY SURRENDER, OR ANY OTHER PROCEEDING IN ANY STATE OR COUNTRY?
10 Have You Ever? IF YES, PLEASE PROVIDE A DETAILED WRITTEN EXPLANATION, INCLUDING THE DATE AND STATE OR COUNTRY WHERE THE DISCIPLINE OCCURRED. YES NO
11 Have You Ever? Have you ever been convicted of any offense other than minor traffic violations? If yes, explain fully as described in the applicant instructions. Convictions must be reported even if they have been adjudicated, dismissed or expunged or if a diversion program has been completed under the Penal Code or Article 5 of the Vehicle Code.
12 Have You Ever? HAD TRAFFIC VIOLATIONS INVOLVING DRIVING UNDER THE INFLUENCE, INJURY TO PERSONS OR PROVIDING FALSE INFORMATION MUST BE REPORTED. THE DEFINITION OF CONVICTION INCLUDES A PLEA OF NOLO CONTENDERE (NO CONTEST), AS WELL AS PLEAS OR VERDICTS OF GUILTY. YOU MUST INCLUDE MISDEMEANOR AS WELL AS FELONY CONVICTIONS.
13
14
15
16
17 Applicant File Review Process Applicant file review prior to July 2010 In July 2010 the application review process was evaluated and changes were made Applications with convictions or license discipline take longer to process
18
19 TOPIC Enforcement issues facing applicants and licensees.
20 Fingerprints FINGERPRINT RESULTS ARE DISSEMINATED AT DIFFERENT LEVELS DEPENDING ON THE ENTITY MAKING THE REQUEST
21 Applicants should be prepared to provide the following documents: Certified arrest (must be verified by arresting agency) and court documents for each conviction Have nursing student obtain certified documents as soon as possible to be submitted with their application for licensure Personal letter of explanation for each incident: Failed the exam; DUI; etc
22 Applicants should be prepared to provide the following documents: Why it happened, what is being done to prevent a reoccurrence Letters of Reference letters from people who knew you during the times of difficulty Work Evaluation(s) from clinical instructors for health related work as a nursing student
23 Applicants should be prepared to provide the following documents: IF EXAM IS FAILED, A 2 ND APPLICATION WILL BE REQUIRED REAPPLY TO TAKE THE EXAM AND GO THROUGH COMPLETE ENFORCEMENT PROCESS AGAIN
24 What Nursing Programs Can Do The school is a lower level screening that the BRN uses for licensure purposes It is recommended the nursing student review documents needed to provide background history prior to entry into the nursing program
25 What Nursing Programs Can Do Be mindful of students, accepted into the program, with a previous conviction Remind students to be truthful and factual in their letter of explanation to the BRN enforcement staff Letters of reference should come from individuals who are aware of any previous conviction(s) and can speak to the applicant s past history
26 What Nursing Programs Can Do Encourage students to submit all required documents at the time the application is submitted to the Board of Registered Nursing Promote alcohol free celebrations when students reach school milestones such as completing finals or graduation to avoid DUIs and other problems.
27 Documents Required Certified arrest and court documents for each conviction Personal letter of explanation for each incident Certified copy of any disciplinary action against a health care related license
28 License Renewal Licensees are required to disclose any convictions or discipline since the last time the California RN license was renewed
29 How is my personal life relevant to my professional life You are a nurse 24 hours a day, 7 days a week Nurses are held to a higher standard than the general public
30 How is my personal life relevant to my professional life WHETHER AN APPLICANT OR A LICENSEE, A NURSE S BEHAVIOR DIRECTLY IMPACTS PUBLIC PERCEPTION OF THE NURSING PROFESSION, NURSING SCHOOLS, AND THE ULTIMATE TRUST, WHEN PLACED IN OUR CARE.
31 Substantial Relationship Criteria CCR Section 1444 An act can be disciplined and can be considered to be substantially related to the qualifications, functions, or duties of a registered nurse, if to a substantial degree it evidences the present or potential unfitness of a registered nurse to practice in a manner consistent with the public health, safety, or welfare.
32 Grounds for Action Drug Related Transgressions B&P Code Section 2762 It is unprofessional conduct for a person licensed under this chapter to do any of the following:
33 B&P Code Section 2762 (a) Obtain, possess, or prescribe, except as directed by licensed MD, DDS, or podiatrist, to administer, furnish, or administer to another, any controlled substance, dangerous drug, or device.
34 B&P Code Section 2762 (b) Use any controlled substance, dangerous drug or device, or alcoholic beverages
35 B&P Code Section 2762 to an extent or in a manner dangerous or injurious to himself/herself, any other person, or the public or to the extent that such use impairs her/her ability to conduct with safety to the public the practice authorized.
36 Controlled Substances Obtained and Possessed in Violation of Law Inconsistent Entries in Hospital Records RN signed the name of another, falsely altered & forged a prescription for Norco. RN obtained Demerol by fraud & deceit by taking the drug from hospital supplies. RN made grossly incorrect & inconsistent entries in hospital and patient records. When tested by hospital RN s sample was 100% water. When tested again, during our investigation, RN admitted to using her 4 year old son s urine. License Revoked
37 B&P Code Section 2762 (c) Be convicted of a criminal offense involving the prescription, consumption or self-administration of, any substance described in (a) or (b),
38 B&P Code Section 2762 or possession of, falsification of a record pertaining to, the substances described in (a), in which event the record of conviction is conclusive evidence
39 Conviction of Crimes Substantially Related to the Qualifications, Functions and Duties of a Registered Nurse RN left the scene of a hit and run accident. Later, RN admitted that he had hit the rear of a vehicle and would pay for the damages. While speaking, officers noticed slurred speech, bloodshot eyes and unsteady gait. RN was transported to Police Department for blood test. BAC.29% Loaded revolver, with hammer cocked, was recovered later from RN s vehicle. License Revoked
40 Alcohol Use and Abuse Drug Use and Abuse misuse of prescription drug Theft Boundaries and/or Sexual Offenses Internet Posting Twitter, Facebook
41 Enforcement Statistics Complaints Received Licensee Disciplinary Actions: Revocation 121 Probation 131 Suspension/Probation 10 License Surrendered 73 Public Reprimand 3 Other Decisions 1 Total, Licenses Disciplined 339
42 Enforcement Statistics Applicant Disciplinary Actions: License Denied 17 License Issued on Probation 10 Total, Applicants Disciplined 27
43 Additional Information for applicants with enforcement issues can be found on our website:
44 QUESTIONS???
45 "Nursing is a work of Heart! anonymous BOARD OF REGISTERED NURSING J A N E T T E WAC K E R LY, M BA, RN S U PE RV I S I N G N U R S I N G E D U C AT I O N CO N S U LTA N T ( )
FLORIDA DEPARTMENT OF HEALTH BOARD OF DENTISTRY
DENTAL RADIOGRAPHY CERTIFICATION APPLICATION Chapter 466.004 and 466.017(5), Florida Statutes Rule 64B5-9.011, Florida Administrative Code SPECIAL TES AND INSTRUCTIONS: 1. A N-REFUNDABLE fee of $35.00
More informationASSOCIATE BROKER STANDARD INITIAL LICENSE APPLICATION
STATE REAL ESTATE COMMISSION PO Box 2649 Harrisburg PA 17105-2649 Phone Number 717-783-3658 Fax Number: 717-787-0250 www.dos.pa.gov/estate ASSOCIATE BROKER STANDARD INITIAL LICENSE APPLICATION Make sure
More informationFLORIDA DEPARTMENT OF HEALTH BOARD OF DENTISTRY
FLORIDA DEPARTMENT OF HEALTH BOARD OF DENTISTRY APPLICATION FOR TEACHING PERMIT Chapter 466.002, Florida Statutes Rule 64B5-7.005, Florida Administrative Code Applications will be accepted only if completed
More informationMailing Address: State Board of Funeral Directors PO Box 2649 Harrisburg, PA 17105-2649 APPLICATION FOR FUNERAL SUPERVISOR LICENSE
48-FS 100 (3/6/15) STATE BOARD OF FUNERAL DIRECTORS Telephone: 717-783-3397 Fax: 717-705-5540 E-mail: st-funeral@state.pa.us Website:w w w.dos.pa.gov/funeral Mailing Address: State Board of Funeral Directors
More informationREQUIREMENTS FOR CERTIFICATION:
Email: st-medicine@pa.gov INITIAL APPLICATION FOR NURSE-MIDWIFE PRESCRIPTIVE AUTHORITY * A separate prescriptive authority collaborative agreement must be submitted for each physician, physician group
More informationREQUIREMENTS FOR LICENSURE:
Email: st-medicine@pa.gov INITIAL APPLICATION FOR A NURSE-MIDWIFE LICENSE 1. This license class does not include prescriptive authority. If you wish to hold a certificate for prescriptive authority, you
More informationHow To Become A Nurse Practitioner In California
BUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY GOVERNOR EDMUND G. BROWN JR. BOARD OF REGISTERED NURSING PO Box 944210, Sacramento, CA 94244-2100 P (916) 322-3350 F (916) 574-8637 www.rn.ca.gov Louise
More informationState of Utah Department of Commerce Division of Occupational and Professional Licensing
State of Utah Department of Commerce Official Use Only Number: Date Approved/Denied: Approved/Denied By: Certified Nurse Midwife APPLICANT INFORMATION Full Legal Name: First Middle Last All Previous Legal
More informationFLORIDA DEPARTMENT OF HEALTH BOARD OF DENTISTRY NON-PROFIT CORPORATION PERMIT APPLICATION
FLORIDA DEPARTMENT OF HEALTH BOARD OF DENTISTRY N-PROFIT CORPORATION PERMIT APPLICATION Applications will be accepted only if completed by an officer of the non-profit organization. Any questions not applicable
More informationFigure: 213.33(b). Texas Board of Nursing Disciplinary Matrix
Figure: 213.33(b). Texas Board of Nursing Disciplinary Matrix In determining the appropriate disciplinary action, including the amount of any administrative penalty to assess, the Board will consider the
More informationMASTER OF ARTS IN COUNSELING
ADMISSIONS REQUIREMENTS / CHECKLIST All applicants to the M.A. in Counseling must: 1. Hold a Bachelor s degree from a recognized institution; 2. Have achieved a minimum 2.75 GPA in undergraduate course
More informationDIVISION OF MEDICAL QUALITY ASSURANCE BOARD OF PHARMACY 4052 BALD CYPRESS WAY, BIN #C-04 TALLAHASSEE, FLORIDA 32399-3254 (850) 245-4292
DIVISION OF MEDICAL QUALITY ASSURANCE BOARD OF PHARMACY 4052 BALD CYPRESS WAY, BIN #C-04 TALLAHASSEE, FLORIDA 32399-3254 (850) 245-4292 PHARMACY TECHNICIAN REGISTRATION APPLICATION AND INSTRUCTIONS October
More informationInstructions For Clinical Nurse Specialist (CNS) Applicants
RETAIN FOR REFERENCE Instructions For Clinical Nurse Specialist (CNS) Applicants GENERAL INFORMATION: An applicant for Clinical Nurse Specialist certification must hold a current, unrestricted license
More informationPENNSYLVANIA STATE BOARD OF DENTISTRY P.O. BOX 2649 HARRISBURG, PA 17105-2649
PENNSYLVANIA STATE BOARD OF DENTISTRY APPLICATION FOR CERTIFICATION AS A PUBLIC HEALTH DENTAL HYGIENE PRACTITIONER Introduction: Instructions and Application Form Please read the following instructions
More informationSTATE OF FLORIDA BOARD OF MASSAGE THERAPY APPLICATION FOR COLON HYDROTHERAPY UPGRADE TO MASSAGE THERAPIST LICENSE WITH INSTRUCTIONS
STATE OF FLORIDA BOARD OF MASSAGE THERAPY APPLICATION FOR COLON HYDROTHERAPY UPGRADE TO MASSAGE THERAPIST LICENSE WITH INSTRUCTIONS Board of Massage Therapy 4052 Bald Cypress Way, Bin # C-06 Tallahassee,
More informationALL APPLICANTS MUST COMPLETE THE FOLLOWING:
APPLICATION FOR ATHLETIC TRAINER LICENSE (This application may also be used for a temporary license) 1. An applicant for licensure shall meet one of the following requirements: a. Be a graduate of an approved
More informationThe apprenticeship Permit and Licensing Requirements
45-CA100 (08/22/14) STATE BOARD OF COSMETOLOGY Telephone: 717-783-7130 Fax: 717-705-5540 E-mail: st-cosmetology@state.pa.us Website:www.dos.state.pa.us/cosmet Mailing Address: PO Box 2649 Harrisburg, PA
More informationNOTE: Practice as a veterinary technician in Pennsylvania may not begin until your license has been issued.
P. O. BOX 2649 HARRISBURG, PA 17105-2649 (717) 783-7134 www.dos.pa.gov/vet APPLICATION for CERTIFICATION as a VETERINARY TECHNICIAN DO NOT use this application to apply for the VTNE NOTE: Practice as a
More informationReciprocity Application 12/2012
The Florida Board of Nursing Certified Nursing Assistants Reciprocity Application 12/2012 Phone.850. 245.4125 Fax.850.412.2207 4052 Bald Cypress Way, BIN C-13 Tallahassee, FL 32399-3252 mqa.cna@flhealth.gov
More informationMANDATORY REPORTING LAWS & RULES
Janet Napolitano Governor Joey Ridenour Executive Director Arizona State Board of Nursing 4747 North 7th Street, Suite 200 Phoenix AZ 85014-3653 Phone (602) 889-5150 Fax (602) 889-5155 E-Mail: arizona@azbn.org
More informationState of Utah Department of Commerce Division of Occupational and Professional Licensing
State of Utah Department of Commerce Official Use Only Number: Date Approved/Denied: Approved/Denied By: Temporary Physical Therapist Temporary Physical Therapist Assistant APPLICANT INFORMATION Full Legal
More informationApplication for New Louisiana Pharmacy Technician Candidate Registration
Louisiana Board of Pharmacy 3388 Brentwood Drive Baton Rouge, Louisiana 70809-1700 Telephone 225.925.6496 ~ Facsimile 225.925.6499 www.pharmacy.la.gov ~ E-mail: info@pharmacy.la.gov Application for New
More information2. Be of good moral character. Have 2 recommendations completed on page 3.
STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P.O. BOX 2649 HARRISBURG, PA 17105-2649 717-783-1389 FAX 717-787-7769 Email st-socialwork@state.pa.us Website www.dos.pa.gov/social
More informationCODE OF PROFESSIONAL CONDUCT EDUCATION PRACTITIONERS
CODE OF PROFESSIONAL CONDUCT for EDUCATION PRACTITIONERS Teachers Educational Staff Associates Administrators STATE OF WASHINGTON Chapter 181-87 WAC Professional Educator Standards Board Administrative
More informationCHECK THE CIRCUMSTANCE UNDER WHICH YOU ARE SEEKING A TEMPORARY LICENSE: REQUIRED DOCUMENTS
Regular Mailing Address P.O. BOX 2649 HARRISBURG, PA 17105-2649 717-783-1400/717-787-2381 Email: st-medicine@pa.gov Courier Delivery Address 2601 NORTH THIRD STREET HARRISBURG, PA 17110 APPLICATION FOR
More informationPLEASE NOTE: If a pending application is older than one year from the date submitted and the applicant wishes to
Rev 07/15 STATE BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY P O BOX 2649 HARRISBURG, PA 17105 717-783-1389 www.dos.pa.gov/speech st-speech@pa.gov Application instructions for Licensure
More informationPLEASE ALLOW AT LEAST 60 DAYS FOR PROCESSING INSTRUCTIONS FOR APPLICANTS WHO HOLD NCCPA CERTIFICATION
Regular Mailing Address P.O. BOX 2649 HARRISBURG, PA 17105-2649 Email: st-medicine@pa.gov Courier Delivery Address 2601 NORTH THIRD STREET HARRISBURG, PA 17110 717-783-1400/717-787-2381 APPLICATION FOR
More informationCERTIFIED MEDICAL LANGUAGE INTERPRETER
STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR CERTIFICATION CERTIFIED MEDICAL LANGUAGE INTERPRETER APPLICATION INSTRUCTIONS AND INFORMATION General Statement: The Utah
More informationBoard of Speech-Language Pathology and Audiology
Board of Speech-Language Pathology and Audiology Application for Speech-Language Pathology or Audiology Provisional Licensure With Instructions Attached Board of Speech-Language Pathology and Audiology
More informationINSTRUCTIONS FOR APPLICANTS WHO HOLD NBRC CERTIFICATION
Email: st-medicine@pa.gov st-osteopahtic@pa.gov Medicine 717-783-1400/717-787-2381 Osteopathic 717-783-4858 APPLICATION FOR LICENSURE AS A RESPIRATORY THERAPIST This application can be used for licensure
More informationSTATE OF FLORIDA BOARD OF MASSAGE THERAPY MASSAGE ESTABLISHMENT CHANGE OF LOCATION/ NAME APPLICATION WITH INSTRUCTIONS
STATE OF FLORIDA BOARD OF MASSAGE THERAPY MASSAGE ESTABLISHMENT CHANGE OF LOCATION/ NAME APPLICATION WITH INSTRUCTIONS Board of Massage Therapy 4052 Bald Cypress Way, #C-06 Tallahassee, FL 32399-3256 (850)
More informationApplication Instructions for: MASSAGE THERAPIST LICENSURE BY EXAMINATION
Regular Mailing Address Courier Delivery Address email: RA-massagetherapy@state.pa.us Application Instructions for: MASSAGE THERAPIST LICENSURE BY EXAMINATION All licenses expire on January 31, of odd-numbered
More informationSTATE OF FLORIDA BOARD OF ACUPUNCTURE APPLICATION FOR LICENSURE WITH INSTRUCTIONS
STATE OF FLORIDA BOARD OF ACUPUNCTURE APPLICATION FOR LICENSURE WITH INSTRUCTIONS Board of Acupuncture 4052 Bald Cypress Way, Bin # C-06 Tallahassee, FL 32399-3256 (850) 488-0595 September 2012 Edition
More informationFederal & State Criminal Background Check. Consent to Fingerprint Background Check
Federal & State Criminal Background Check Superior School District #3 (SSD3) requires that a national & state criminal history background check, including fingerprinting, be completed for all candidates
More informationAPPLICATION FOR ACCREDITATION AS A CLAIMS AGENT OR ATTORNEY
Form Approved, OMB No. 2900-0605 Respondent Burden: 45 minutes APPLICATION FOR ACCREDITATION AS A CLAIMS AGENT OR ATTORNEY INSTRUCTIONS: Please provide the applicable personal and employment data, then
More informationPHYSICAL THERAPIST ASSISTANT LICENSURE by ENDORSEMENT
STATE BOARD OF PHYSICAL THERAPY P. O. BOX 2649 717-783-7134 www.dos.pa.gov/physther Application for PHYSICAL THERAPIST or PHYSICAL THERAPIST ASSISTANT LICENSURE by ENDORSEMENT REQUIREMENTS - 1. Graduation
More informationOCCUPATIONAL THERAPY ASSISTANT or OCCUPATIONAL THERAPIST
STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR LICENSURE OCCUPATIONAL THERAPY ASSISTANT or OCCUPATIONAL THERAPIST APPLICATION INSTRUCTIONS AND INFORMATION General Statement:
More informationAPPLICATION FOR LICENSURE AS A PSYCHOLOGIST
APPLICATION FOR LICENSURE AS A PSYCHOLOGIST Application Fee: $40 (Nonrefundable) File #: SECTION I. PErSONAl DATA (Board use only) Last First Middle Initial Jr., Sr., I, II (Note: Formal identification
More informationAPPLICATION FOR A LICENSE BY EXAMINATION TO PRACTICE MARRIAGE AND FAMILY THERAPY
QUALIFICATIONS STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P.O. BOX 2649 HARRISBURG, PA 17105-2649 Email st-socialwork@state.pa.us Website www.dos.pa.gov/social
More informationState of Utah Department of Commerce Division of Occupational and Professional Licensing
State of Utah Department of Commerce Division of Occupational and Professional Licensing Official Use Only Number: Date Approved/Denied: Approved/Denied By: Retired Volunteer Health Care Practitioner APPLICANT
More informationEligibility Requirements for RN Licensure in the State of Texas
February 2015 1 Eligibility Requirements for RN Licensure in the State of Texas These requirements listed here are not exclusive. It is the student s responsibility to update themselves with all requirements
More informationSIGNATURES & DATED COPY ON FILE IN BOARD OFFICE
In the Matter of Jennifer Ramberg, CNA BEFORE THE OREGON STATE BOARD OF NURSING ) STIPULATED ORDER FOR ) PROBATION Certificate No. 200212542CNA ) Reference No. 15-00992 Jennifer Ramberg (CNA) was issued
More informationPENNSYLVANIA STATE BOARD OF NURSING PHONE (717) 783-7142 P.O. BOX 2649 FAX (717) 783-0822
PENNSYLVANIA STATE BOARD OF NURSING PHONE (717) 783-7142 P.O. BOX 2649 FAX (717) 783-0822 HARRISBURG, PA 17105-2649 www.dos.pa.gov/nurse Email: st-nurse@pa.gov Instructions For Certified Registered Nurse
More informationInstructions Checklist
PENNSYLVANIA STATE BOARD OF DENTISTRY P.O. BOX 2649 HARRISBURG, PA 17105-2649 APPLICATION FOR A LICENSE TO PRACTICE DENTAL HYGIENE Instructions and Application Form Introduction: Please read the following
More informationPENNSYLVANIA STATE BOARD OF NURSING PHONE (717) 783-7142 P.O. BOX 2649 FAX (717) 783-0822
PENNSYLVANIA STATE BOARD OF NURSING PHONE (717) 783-7142 P.O. BOX 2649 FAX (717) 783-0822 HARRISBURG, PA 17105-2649 www.dos.state.pa.us/nurse Email: st-nurse@state.pa.us RETAIN FOR REFERENCE General Instructions
More informationState of Utah Department of Commerce Division of Occupational and Professional Licensing
State of Utah Department of Commerce Official Use Only Number: Date Approved/Denied: Approved/Denied By: Veterinarian APPLICANT INFORMATION Full Legal Name: First Middle Last All Previous Legal Names:
More informationAPPLICATION FOR A LICENSE TO PRACTICE SOCIAL WORK (THIS APPLICATION MUST BE SUBMITTED FOR PRE-APPROVAL TO TAKE THE ASWB MASTER S EXAMINATION)
STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P O BOX 2649 HARRISBURG, PA 17105 717-783-1389 st-socialwork@pa.gov Fax 717-787-7769 www.dos.pa.gov/social APPLICATION
More informationREVISED 07-15 STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P.O. BOX 2649 HARRISBURG, PA 17105-2649
STATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PROFESSIONAL COUNSELORS P.O. BOX 2649 HARRISBURG, PA 17105-2649 Email st-socialwork@pa.gov www.dos.pa.gov/social APPLICATION FOR A LICENSE
More informationAPPLICATION INSTRUCTIONS
WASHINGTON STATE PROFESSIONAL TEACHER CERTIFICATE RENEWAL REQUIREMENTS This application is for renewal of a professional teaching certificate. Individuals who hold professional administrative or educational
More informationINSTRUCTIONS FOR APPLICANTS WHO HOLD NBRC CERTIFICATION
Email: st-medicine@pa.gov st-osteopahtic@pa.gov Medicine 717-783-1400/717-787-2381 Osteopathic 717-783-4858 APPLICATION FOR LICENSURE AS A RESPIRATORY THERAPIST This application can be used for licensure
More informationProgram Fact Sheet. Contact Odessa College School of Vocational Nursing- Monahans Center for application deadline.
Department Faculty and Staff: Monahans Extension Odessa College School of Vocational Nursing Monahans Center Program Fact Sheet Nancy Kilgore, R.N. Director of Nursing Ann McCalister, R.N., Instructor
More informationDEPARTMENT OF HEALTH. APPLICATION FOR LIMITED LICENSURE and Instructions
DEPARTMENT OF HEALTH BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING APPLICATION FOR LIMITED LICENSURE and Instructions APPLICATION FOR LIMITED LICENSURE INSTRUCTIONS
More informationBOARD OF ATHLETIC TRAINING STATE OF FLORIDA EXAMINATION APPLICATION FOR LICENSURE
BOARD OF ATHLETIC TRAINING STATE OF FLORIDA EXAMINATION APPLICATION FOR LICENSURE You must read the laws and rules in order to determine your eligibility for licensure. Chapter 468, Part XIII, Florida
More informationINFORMATION/INSTRUCTION SHEET CERTIFIED PODIATRIC X-RAY ASSISTANT
Chapter 461, Florida Statutes Rule Chapter 64B18-24, Florida Administrative Code INFORMATION/INSTRUCTION SHEET CERTIFIED PODIATRIC X-RAY ASSISTANT Any Certified Podiatric X-ray Assistant may perform services
More informationTexas Board of Nursing 333 Guadalupe, Ste 3-460, Austin, TX 78701 Phone: 512-305-7400
For Office Use Only Date: Amount: Texas Board of Nursing 333 Guadalupe, Ste 3-460, Austin, TX 78701 Phone: 512-305-7400 PETITION FOR DECLARATORY ORDER Audit #: FBI HX: YES NO Complete this application
More informationMassage Therapist Licensure Application
Massage Therapist Licensure Application Do Not Write in this Space For Revenue Receipting Only Florida Board of Massage Therapy PO Box 6330 Tallahassee, FL 32314-6330 Web: www.floridasmassagetherapy.gov
More informationOREGON MEDICAL BOARD PROCESSES AND UPDATES. Kathleen Haley, Executive Director Oregon Medical Board
OREGON MEDICAL BOARD PROCESSES AND UPDATES Kathleen Haley, Executive Director Oregon Medical Board Mission Statement The mission of the OREGON MEDICAL BOARD is to protect the health, safety and wellbeing
More informationGUIDING PRINCIPLES FOR MICHIGAN INSURANCE PRODUCER LICENSURE
GUIDING PRINCIPLES FOR MICHIGAN INSURANCE PRODUCER LICENSURE Department of Insurance and Financial Services Office of Insurance Licensing and Market Conduct Revised Page 1 of 9 Introduction A primary mission
More informationIOWA PLUMBING & MECHANICAL SYSTEMS BOARD
IOWA PLUMBING & MECHANICAL SYSTEMS BOARD Contractor License Renewal Form Instructions Enclosed is an application for renewal of your Iowa Plumbing & Mechanical Systems Board contractor license. To expedite
More informationVOCATIONAL REHABILITATION COUNSELOR
STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR LICENSURE VOCATIONAL REHABILITATION COUNSELOR APPLICATION INSTRUCTIONS AND INFORMATION General Statement: The Utah Division
More informationAPPLICATION FOR EFDA CERTIFICATION BY EXAMINATION
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS STATE BOARD OF DENTISTRY P O BOX 2649 Telephone: (717) 783-7162 Website: www.dos.state.pa.us/dent Fax: (717)
More informationApplication Instructions for:
Regular Mailing Address Courier Delivery Address P.O. Box 2649 2601 North Third Street Phone: 717-783-7155 email:ra-massagetherapy@state.pa.us Application Instructions for: MASSAGE THERAPIST TEMPORARY
More informationThis is a Legal Document. By completing and signing, this you certify under
APPLICATION FOR WYOMING NURSING ASSISTANT CERTIFICATION (CNA) BY ENDORSEMENT, or DEEMING *All certificates expire December 31 of every EVEN year* This is a Legal Document. By completing and signing, this
More information10 CSR 2. 1.1. Scope. -- This legislative rule establishes the Policies Regulating Licensure of the Licensed Practical Nurse.
10 CSR 2 TITLE 10 LEGISLATIVE RULES WEST VIRGINIA STATE BOARD OF EXAMINERS FOR LICENSED PRACTICAL NURSES SERIES 2 POLICIES REGULATING LICENSURE OF THE LICENSED PRACTICAL NURSE '10-2-1. General. 1.1. Scope.
More informationBoard of Speech-Language Pathology and Audiology
Board of Speech-Language Pathology and Audiology Application for Speech-Language Pathology or Audiology Assistant Certification With Instructions Attached Board of Speech-Language Pathology and Audiology
More informationCERTIFICATE OF AUTHORITY (COA) INSTRUCTIONS AND REQUIREMENTS FAQ S
CERTIFICATE OF AUTHORITY (COA) INSTRUCTIONS AND REQUIREMENTS Eligibility for a COA to practice as a Certified Nurse Midwife (CNM), Certified Nurse Practitioner (CNP), Certified Nurse Specialist (CNS) or
More informationBEFORE THE BOARD OF PHARMACY DEPARTMENT OF CONSUMER AFFAIRS STATE OF CALIFORNIA. Respondent. PARTIES
KAMALA D. HARRIS Attorney General of California ARTHURD. TAGGART Supervising Deputy Attorney General ELENA L. ALMANZO Deputy Attorney General State BarNo. 0 0 I Street, Suite 1 P.O. Box Sacramento, CA
More informationCHAPTER 11 LICENSURE OF NURSES IN FLORIDA, THE CREDENTIALS COMMITTEE AND QUESTIONS AND ANSWERS
CHAPTER 11 LICENSURE OF NURSES IN FLORIDA, THE CREDENTIALS COMMITTEE AND QUESTIONS AND ANSWERS The basic licensure requirements for nurses in Florida are enacted into law by the Florida Legislature. Licensure
More informationAPPLICATION for LICENSURE in VETERINARY MEDICINE DO NOT use this application to apply for the NAVLE
STATE BOARD OF VETERINARY MEDICINE P. O. BOX 2649 HARRISBURG, PA 17105-2649 (717) 783-7134 www.dos.pa.gov/vet APPLICATION for LICENSURE in VETERINARY MEDICINE DO NOT use this application to apply for the
More informationImportant Information for all Applicants
Important Information for all Applicants You must have a current Florida RN license to apply for a CNS Upgrade. For Clinical Nurse Specialist licensure requirements, refer to Sections 464.008, 464.009,
More informationFINGERPRINT BACKGROUND CHECK
APPLICATION FOR LICENSURE PHARMACY TECHNICIAN (Non-Renewable: Expires the second June 30 from the date of issuance) OR CERTIFIED OREGON PHARMACY TECHNICIAN (Renewable: Expires September 30 th Annually)
More informationArticle 6. Background Check 87355 CRIMINAL RECORD CLEARANCE 87355
Regulations RESIDENTIAL CARE FACILITIES FOR THE ELDERLY 87355 (Cont.) Article 6. Background Check 87355 CRIMINAL RECORD CLEARANCE 87355 (a) (b) The Department shall conduct a criminal record review of
More informationRADIOLOGIC TECHNOLOGIST or RADIOLOGY PRACTICAL TECHNICIAN
STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR LICENSURE RADIOLOGIC TECHNOLOGIST or RADIOLOGY PRACTICAL TECHNICIAN APPLICATION INSTRUCTIONS AND INFORMATION General Statement:
More informationDISCIPLINARY GUIDELINES AND UNIFORM STANDARDS RELATED TO SUBSTANCE ABUSE
State of California Board of Vocational Nursing and Psychiatric Technicians DISCIPLINARY GUIDELINES AND UNIFORM STANDARDS RELATED TO SUBSTANCE ABUSE Revised June 20, 2011 (Regulations Effective December
More informationDepartment of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing
MED THE STATE of ALASKA Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing State Medical Board PO Box 110806, Juneau, AK 99811-0806
More informationState of Utah Department of Commerce Division of Occupational and Professional Licensing
State of Utah Department of Commerce Division of Occupational and Professional Licensing Official Use Only Number: Date Approved/Denied: Approved/Denied By: Psychologist APPLICANT INFORMATION Full Legal
More informationDepartment of Health
Department of Health Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling MARRIAGE AND FAMILY THERAPY DUAL LICENSURE APPLICATION Qualifications for Marriage and Family
More informationAPPLICANTS MUST COMPLETE THE FOLLOWING:
Regular Mailing Address P.O. BOX 2649 HARRISBURG, PA 17105-2649 717-783-1400/717-787-2381 Email: st-medicine@pa.gov Courier Delivery Address 2601 NORTH THIRD STREET HARRISBURG, PA 17110 APPLICATION FOR
More informationUNIVERSITY OF NORTH DAKOTA SUBSTANCE ABUSE POLICY FOR FACULTY AND STAFF
UNIVERSITY OF NORTH DAKOTA SUBSTANCE ABUSE POLICY FOR FACULTY AND STAFF PURPOSE The University of North Dakota recognizes that the use of illegal drugs, and abuse of alcohol and prescription drugs is a
More informationGeneral Instructions for Certified Registered Nurse Practitioner (CRNP) Certification Applicants
PENNSYLVANIA STATE BOARD OF NURSING PHONE: (717) 783-7142 P.O. BOX 2649 FAX: (717) 783-0822 HARRISBURG, PA 17105-2649 www.dos.state.pa.us/nurse Email: st-nurse@pa.gov RETAIN FOR REFERENCE General Instructions
More information13 HB 315/AP A BILL TO BE ENTITLED AN ACT
House Bill 315 (AS PASSED HOUSE AND SENATE) By: Representatives Cooper of the 43 rd, Clark of the 101 st, Rynders of the 152 nd, Kaiser of the 59 th, Jones of the 53 rd, and others A BILL TO BE ENTITLED
More informationA $100.00 application fee in the form of a money order made payable to LSBN must accompany this form
OFFICE USE ONLY: APPROVED BY (initial) DATE PERMIT ISSUED RN LICENSE NUMBER DATE RN LICENSE ISSUED ATTACH PHOTO With tape only - Attach a 2 x 2 inch passport type, fade-proof photo taken in the last six
More informationRESIDENCY RENEWAL OR PROFESSIONAL EDUCATIONAL STAFF ASSOCIATE CERTIFICATION REQUIREMENTS School Counselor and School Psychologist
RESIDENCY RENEWAL OR PROFESSIONAL EDUCATIONAL STAFF ASSOCIATE CERTIFICATION REQUIREMENTS School Counselor and School Psychologist In Washington, certain specialists who serve in the K-12 schools are certified
More informationDIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING
Statutes and Regulations Behavior Analysts December 2014 (Centralized Statutes and Regulations not included) DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT DIVISION OF CORPORATIONS, BUSINESS
More informationBOARD OF CHIROPRACTIC MEDICINE GENERAL INFORMATION/INSTRUCTIONS REGISTERED CHIROPRACTIC ASSISTANT
BOARD OF CHIROPRACTIC MEDICINE GENERAL INFORMATION/INSTRUCTIONS REGISTERED CHIROPRACTIC ASSISTANT HOW TO APPLY FOR FLORIDA LICENSURE *** PLEASE TYPE OR PRINT IN BLACK INK - PLEASE READ CAREFULLY *** 1.
More informationEMERGENCY SUBSTITUTE CERTIFICATION REQUIREMENTS EMERGENCY SUBSTITUTE CERTIFICATION CHECKLIST
EMERGENCY SUBSTITUTE CERTIFICATION REQUIREMENTS School districts, private schools or educational service districts that have exhausted or reasonably anticipates they will exhaust their list of qualified
More informationName: Last First Middle. Mailing Address: Street City/State Zip Street Address: Street City/State Zip Telephone: ( ) Social Security Number:
School Nurse Application for Employment TANQUE VERDE UNIFIED SCHOOL DISTRICT, NO. 13 11150 E. Tanque Verde Road Tucson, AZ 85749 520-749-5751 / fax 520-749-5400 All positions require an Arizona Registered
More information12 LC 33 4750S A BILL TO BE ENTITLED AN ACT BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
The House Committee on Health and Human Services offers the following substitute to SB 368: A BILL TO BE ENTITLED AN ACT 1 2 3 4 5 To amend Chapter 26 of Title 43 of the Official Code of Georgia Annotated,
More informationYOU CAN TAKE CONTROL!
YOUR DEGREE, YOUR CAREER... YOU CAN TAKE CONTROL! Alcohol Violations and Their Effect on Your Employment After Graduation ALC OHOL EDUCATION Table of Contents Introduction... Pennsylvania Law - What You
More informationAPPLICATION FOR LICENSURE LICENSED SUBSTANCE ABUSE COUNSELOR CERTIFIED SUBSTANCE ABUSE COUNSELOR CERTIFIED SUBSTANCE ABUSE COUNSELOR INTERN
STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR LICENSURE LICENSED SUBSTANCE ABUSE COUNSELOR CERTIFIED SUBSTANCE ABUSE COUNSELOR CERTIFIED SUBSTANCE ABUSE COUNSELOR INTERN
More informationAPPLICATION FOR A BEHAVIOR SPECIALIST LICENSE
Email: st-medicine@pa.gov (01/2016) APPLICATION FOR A BEHAVIOR SPECIALIST LICENSE An application SHOULD NOT be submitted until you have obtained a master s or post master s degree in an approved field
More informationNew Jersey Physician Recredentialing Application (Please type or print)
New Jersey Physician Recredentialing Application (Please type or print) All sections must be completed fully or clearly marked as not applicable. No area should be left blank. SECTION 1 Personal Information
More informationKentucky Board of Medical Licensure 310 Whittington Parkway, Suite 1B Louisville, KY 40222 (502) 429-7150
Kentucky Board of Medical Licensure 310 Whittington Parkway, Suite 1B Louisville, KY 40222 (502) 429-7150 M E M O R A N D U M TO: FROM: RE: Applicants for Surgical Assistant Certification Dawn Beahl, Surgical
More informationState of California Board of Registered Nursing Recommended Guidelines for Disciplinary Orders and Conditions of Probation
State of California Board of Registered Nursing Recommended Guidelines for Disciplinary Orders and Conditions of Probation (Revised 10/02) Effective 05/24/03 TABLE OF CONTENTS Page Number Introduction
More information3416 1 st Avenue North Billings, MT. Phone 245-4946. Will do fingerprinting Monday Friday, 8:00-5:00. $12.00 per card
Federal Criminal Background Check The College of Education at Montana State University Billings (MSU B) requires that a national criminal history background check, including fingerprinting, be completed
More informationFLORIDA DEPARTMENT OF HEALTH BOARD OF DENTISTRY APPLICATION FOR LIMITED LICENSURE DENTIST/DENTAL HYGIENIST
Statute and Rule References: -Section 456.015, Florida Statutes -Rule 64B5-7.007, Florida Administrative Code APPLICATION FOR LIMITED LICENSURE DENTIST/DENTAL HYGIENIST General Requirements and Information
More informationCERTIFYING ORGANIZATION CERTIFICATION TYPE EFFECTIVE DATE EXPIRATION DATE
Fee $105.00 U.S. No personal checks. All fees are nonrefundable. 2829 University Avenue SE #200 Minneapolis, MN 55414-3253 (612) 317-3000 Voice (612) 617-2190 Fax Toll Free (888) 234-2690 (MN, IA, ND,
More informationSTATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR LICENSURE PHYSICAL THERAPIST
STATE OF UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING APPLICATION FOR LICENSURE PHYSICAL THERAPIST APPLICATION INSTRUCTIONS AND INFORMATION General Statement: The Utah Division of Occupational
More informationPLEASE READ BEFORE COMPLETING APPLICATION
PLEASE READ BEFORE COMPLETING APPLICATION Information for Licensure: SOCIAL WORKER (LSW) Each item on the enclosed application must be completed. Allow 30 days for processing of the application. Failure
More information