Get Nurse Form 3

The Nurse Form 3 is essential for individuals who hold or have held a professional license or certification in any jurisdiction. This guide will provide clear, step-by-step instructions to assist users in completing the form accurately and efficiently.

Follow the steps to complete the Nurse Form 3 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in Section I with your personal information. In item 4, ensure that you enter your name exactly as it appears on your Application for Licensure (Form 1). Also, complete your Social Security Number and date of birth in the specified fields.
3. Provide your mailing address in item 5, making sure to notify the Department of any changes to your address or name promptly.
4. In item 6, specify the name of the licensing or certifying authority to which the form will be sent. If applicable, print your name as it appears on your license or certificate in item 7.
5. If you took any licensing examination under a different name, ensure you list that name in item 8.
6. Input the name of your nursing school and the date of your nursing diploma in item 9.
7. In item 10, sign and date the form, granting permission for the licensing authority to complete the form and return it to the New York State Education Department.
8. Review all sections for accuracy before sending the entire form to the appropriate licensing or certifying authority to complete Section II.

Complete your Nurse Form 3 today to ensure a smooth application process.