Get Form B - Please Check Appropriate Profession

Filling out FORM B - PLEASE CHECK APPROPRIATE PROFESSION is an essential step in the licensure application process for various healthcare professions. This guide provides you with clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to accurately complete the online form.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by printing your last name in the designated field at the top of the form. Ensure clarity, as this information is critical for identification.
3. Select your appropriate profession from the provided list by marking the corresponding checkbox. Options include acupuncturist, athletic trainer, physician assistant, and others.
4. Print your first name in the specified area below your last name. This should also be clear and legible.
5. Provide the name and address of the setting or organization exactly as it appears on your application chronology. Fill this out carefully for accuracy.
6. Enter the last four digits of your Social Security Number in the provided field. Then, proceed to fill in your complete address, including city, state, and zip code.
7. Complete the section where you authorize the Virginia Board of Medicine to obtain necessary information from relevant institutions and individuals. Your signature is required here.
8. Fill in the date and type of service information where indicated. Include the time period of service using Month/Year.
9. In the evaluation section, provide your insights on the applicant's skills by marking the appropriate boxes, ranging from poor to superior based on your observations.
10. For the recommendation section, indicate your recommendation level by checking the relevant box and provide explanations if necessary.
11. Offer any notable comments regarding the applicant’s strengths and weaknesses to provide additional context.
12. Indicate how the report was formulated by marking the relevant checkboxes, including any necessary explanations.
13. Finally, enter the date, provide your contact number, sign the form, print or type your name, and include your title before submitting.
14. Once you have completed all sections, remember to save your changes. You may also choose to download, print, or share the completed form as required.

Complete your documents online to ensure a smooth and timely application process.