Follow the steps to complete your online renewal form:

1. Press the ‘Get Form’ button to access the renewal form and open it in your browser.
2. Begin by entering your license number in the designated field to confirm your identity. This information is essential for retrieving your license details.
3. Input your full name as it appears on your current license in the next section. Ensure accuracy to avoid delays in processing.
4. If you have changed your address since your last renewal, select the option indicating this and provide your new mailing address, including street or PO Box, city, county, state, and zip code.
5. Next, provide your residence address if it differs from your mailing address. Ensure that both addresses are current.
6. Enter your telephone and cell number for communication purposes, along with your email address.
7. If applicable, enter your National Provider Identifier (NPI) in the respective field.
8. If you wish to change your license type, select the appropriate option and provide the necessary supporting documentation, such as proof of liability insurance or continuing education credits.
9. Complete the section on professional activities only if you are applying for an exempt license type. Choose from the listed activities you intend to engage in.
10. Respond to the series of questions regarding any disciplinary actions, legal actions, or changes in your professional status over the past year. Accurate responses are critical.
11. If applicable, indicate whether you supervise any Physician Assistants or Athletic Trainers and list their names and license numbers.
12. You will need to confirm whether you maintain a policy of liability insurance. Provide the insurer, policy number, and effective dates if applicable.
13. If you perform office-based surgeries, answer accordingly and provide details of your Kansas hospital privileges.
14. Indicate your willingness to be included on a registry for providing professional services during emergencies.
15. Complete the continuing education section by confirming that you have met the required CME hours. Do not mail proof unless changing your license type.
16. In the final sections, provide any additional licensing information, such as authority from other states and whether you dispense prescription medications.
17. After completing all sections, carefully review your entries to ensure accuracy. You may then save your changes, download, or print a copy of the form for your records.

Complete your online renewal form today to maintain your license without inconvenience.