Get Ncrcb

Filling out the North Carolina Respiratory Care Board (Ncrcb) late renewal form online can be straightforward with the right guidance. This comprehensive guide provides step-by-step instructions to help users successfully complete the form with clarity and ease.

Follow the steps to complete your late renewal form online.

1. Press the ‘Get Form’ button to access the document and open it for editing.
2. In Section A, provide your personal information including your full name, mailing address, physical address (if different), social security number, telephone number, RCP license number, and email address. Ensure that all information is accurate and up to date.
3. Answer the questions regarding any felony or misdemeanor convictions and any disciplinary actions. If you have previously informed the Board of any incidents, check 'Yes' and note that you have acknowledged these to the Board.
4. In Section B, list your current practice site(s). If you are currently inactive, mark 'N/A' in this section. Provide additional sheets if necessary.
5. For Section C, complete the affidavit by certifying that you are the individual referred to in the application, and that the information is true. Include your signature and the date signed.
6. Attach a copy of your current Basic Life Support certification and any continuing education completed since your last renewal.
7. Indicate the expiration date of your current CRT credential, or write 'N/A' if it does not have an expiration date.
8. Review the fee section, where a renewal and late renewal fee of $150.00 is required. Ensure payment is made to the North Carolina Respiratory Care Board using an acceptable payment method.
9. Once you have completed all sections, save any changes, and you may choose to download, print, or share the form as needed.

Start completing your Ncrcb late renewal form online today!