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How to fill out the 848 Iac 5 1 1 Form online
The 848 Iac 5 1 1 Form is essential for advanced practice nurses seeking prescriptive authority for legend drugs in Indiana. This guide provides clear and supportive instructions for completing the form online effectively.
Follow the steps to complete the 848 Iac 5 1 1 Form online.
- Click the ‘Get Form’ button to access the document and open it for editing.
- Begin by filling in your complete name, residence and office addresses with zip codes, and contact numbers. Ensure accuracy as this information is vital.
- List all names you have used in the past along with explanations for any changes.
- Enter your date and place of birth, along with your citizenship and visa status, if relevant.
- Detail your nursing education, including names and locations of educational institutions, dates of attendance, and degrees obtained.
- Provide a comprehensive list of your employment history, detailing names and addresses of employers, dates of each employment, and your responsibilities in each role.
- Disclose any past disciplinary actions against your nursing license, including the details and dates relevant to those actions.
- Answer questions regarding past addiction to narcotic drugs or any criminal convictions related to drug abuse.
- Confirm whether you have been licensed in other states and provide the relevant details.
- Sign the application statement confirming the truthfulness of your submissions, as all information must be provided under oath.
- After completing the form, review all entries for accuracy and completeness before proceeding to submit.
- Once satisfied, save your changes, download a copy for your records, and print or share the completed form as required.
Complete the necessary documents online to ensure a smooth application process.
Applying for the NCLEX in Indiana starts with submitting an application to the Indiana State Board of Nursing. You will need to complete the 848 Iac 5 1 1 Form to ensure that all your required documents are in order. Once your application is reviewed and accepted, you will receive an authorization to test, which you need to schedule your NCLEX exam. It’s beneficial to keep track of your application status during this time.
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