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Get Verification Of Theory And Clinical Instruction Form - Ct.gov
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How to fill out the Verification Of Theory And Clinical Instruction Form - CT.gov online
This guide provides comprehensive instructions on completing the Verification Of Theory And Clinical Instruction Form - CT.gov. It aims to support users through the online process, ensuring clarity and ease in each step.
Follow the steps to effectively complete the verification form.
- Press the ‘Get Form’ button to access the form and open it in your preferred editor.
- Fill in the name of the individual applying for practical nurse licensure in the designated field.
- Enter the applicant's social security number accurately in the provided section.
- Specify the name of the educational institution from which the applicant graduated in the respective field.
- Indicate the country where the educational institution is located.
- Provide the enrollment dates by entering the start date in the 'Enrolled From' section and the end date in the 'To' section.
- Educational institutions should complete the next sections detailing the total months and hours completed by the applicant, ensuring values reflect the actual training received.
- Record the total amount of supervised direct client care and observational experience in the designated fields.
- Select 'Yes' or 'No' to indicate whether the applicant received a degree, diploma or certificate in nursing, and note the completion status of the program.
- If the answer to the completion status is 'No', provide a detailed explanation in the space provided.
- Include the signature of the authorized person from the educational institution, along with their title and the date of completion.
- Complete the day-time telephone number and email address fields to facilitate communication.
- Once all fields are filled, you can save changes, download, print, or share the completed form as needed.
Complete your Verification Of Theory And Clinical Instruction Form online today.
To reach out concerning the CT nursing license, you can either call the Connecticut nursing board at 860-509-7603 or visit CT for online resources. They are available to help you with any questions regarding nursing practice, licensing issues, or renewals. Clear communication with the board can ensure that you receive the support you need.
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