Get Application For A License To Practice As A Genetic ... - In

Completing the application for a license to practice as a genetic counselor is a critical step in your professional journey. This guide provides clear, step-by-step instructions to help you navigate the online form, ensuring that you provide all necessary information accurately.

Follow the steps to successfully complete your application online.

1. Click the ‘Get Form’ button to access the application and open it in your preferred online editor.
2. Enter your personal details in the applicant information section, including your name, Social Security number, date of birth, and mailing address. Ensure that all information is accurate and reflects your current status.
3. Indicate whether you wish to apply for a temporary permit and provide the date of your scheduled examination if applicable.
4. Complete the education section by listing your undergraduate and graduate education, including the names of the institutions, dates attended, addresses, graduation dates, and degrees earned.
5. Provide your employment history for the last five years or since graduation, including the name of your employers, employment dates, locations, job titles, and contact information.
6. Fill out the certification examination details, specifying your certifying body and the dates you passed the examinations.
7. If applicable, list any state licenses you hold related to genetic counseling, providing details such as license type, state, license number, year of issue, and current status.
8. Address any questions regarding disciplinary actions or convictions by answering truthfully and providing necessary explanations in a signed and notarized statement where applicable.
9. Affirm the truthfulness of your application by signing and dating the application at the designated area.
10. Complete the authorization for release of information section, ensuring that this portion is signed and dated as well.
11. If applying for a temporary permit, complete the supervisor’s statement with relevant details about your supervisor and obtain their certification of supervision.
12. Once all sections are completed, save your changes, download a copy for your records, or print the application if needed.

Take the next step in your career by completing your application online today!