Get Ak Form 08-4028 2014-2025

Filling out the AK Form 08-4028 online can streamline your application process for Advanced Nurse Practitioner Authorization in Alaska. This guide will provide you with clear, step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete your application online.

1. Click ‘Get Form’ button to access the application form and open it in your preferred online editor.
2. Fill in your personal information: Include your last name, first name, middle initial, and maiden name as required. Ensure all details are entered clearly.
3. Provide your mailing address: Enter your street address or P.O. Box, along with your city, state, and zip code.
4. Complete the remaining personal details: Input your date of birth, daytime telephone number, and U.S. Social Security Number to comply with state regulations.
5. Indicate your educational background: Fill in the nurse practitioner program details, including the start and end dates, as well as whether you hold national certification.
6. Select the population focus of your practice: Choose the appropriate options that apply to your role from the provided categories.
7. Document your advanced nurse practitioner experience: List your employer's name and address along with the timeframe and scope of practice.
8. Complete any sections regarding prescriptive authority if applicable: Indicate whether you want authority for legend drugs and provide necessary educational documentation.
9. Fill in the information for references: List three professional references and ensure you send them the enclosed reference form for verification.
10. Sign the application in front of a notary: Ensure you comply with the requirement for notarization as stated in the application form.
11. Submit your application: Save the completed form, and then download, print, or share it as needed based on your next steps.

Start filling out your AK Form 08-4028 online today to advance your nursing career in Alaska.