Get Nursing Service Deferment/cancellation Form - Riseup!

Filling out the Nursing Service Deferment/Cancellation Form properly is essential for ensuring that your request is processed smoothly. This guide will provide you with clear, step-by-step instructions on completing the form online, tailored to meet your needs.

Follow the steps to successfully complete the form online.

1. Click the ‘Get Form’ button to access the Nursing Service Deferment/Cancellation Form and open it in the designated editor.
2. Begin by filling out the personal information section. Enter your name, social security number, ECSI account number, street address, city, state, zip code, date of birth, email address, and phone numbers (home, cell, work). Make sure all information is accurate to avoid processing delays.
3. Indicate the deferment period by entering both the start and end dates for the requested duration. Note that a request for service deferment is expected at the beginning of each required service year.
4. If applicable, fill in the cancellation period. Provide the beginning and ending dates for the cancellation period. Remember that cancellation requests should be made at the end of each required service year, and altered dates are not accepted.
5. In the certification section, confirm your employment status by indicating whether you were employed as a full-time or part-time registered nurse or a full-time nursing instructor, along with the relevant hospital, clinic, or school name and address.
6. Sign and date the form to certify that the information provided is true. Ensure that the social security number and service period dates are accurately filled, as these are necessary for processing.
7. Once you have completed all sections, save your changes. You may also opt to download, print, or share the form as needed.

Take the next step in your nursing journey by completing the Nursing Service Deferment/Cancellation Form online today!