Get Nevada State Board Of Nursing Form

Filling out the Nevada State Board Of Nursing Form online is essential for submitting your list of nursing personnel accurately and efficiently. This guide provides step-by-step instructions to help you complete the form, ensuring that you meet all necessary requirements and deadlines.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of your agency or facility. If this is a new name, indicate that it is a new agency/facility.
3. Next, provide the complete address of your agency or facility, including street address, city, state, and ZIP code. Indicate if this is a new address as well.
4. Identify the nursing administrator responsible for the accuracy of the information. Include their name and contact telephone number, ensuring to use the area code.
5. In the designated section, affirm that your facility has verified the status of all nursing personnel listed. This includes confirmation that they hold valid active licenses or certifications. Ensure the nursing administrator's signature is included, along with the date and title.
6. For each nursing personnel listed, enter the following details in the appropriate columns: last name, first name, permanent Nevada license/certificate number, temporary Nevada license/certificate number, Nevada interim permit number, and the expiration date of their licenses or certificates.
7. Once you have completed filling out the form, review all entries for accuracy. You can then save the changes, download the completed form, print it, or share it as needed.

Complete your documents online for a seamless submission process.