
01/2019Application Information for Nebraska Podiatry License License Fee: Use the chart below to determine your applicable licensing fee. The prorated fee is applicable if the Licensure Unit issues.
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How to fill out the NE DHHS Application Information Podiatry License online
Filling out the NE DHHS Application Information for a Podiatry License is a vital step in your journey to practice podiatry in Nebraska. This guide provides a clear, step-by-step approach to assist you in completing the online application process accurately and efficiently.
Follow the steps to successfully complete your application.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Provide your personal information in Section A, including your legal name, mailing address, date, and place of birth. Remember to include your Social Security Number.
- In Section B, disclose any conviction information you may have. You are required to submit relevant court records and a letter of explanation for all convictions.
- Complete Section C by indicating whether you have had your fingerprints taken and if you have paid for fingerprint processing.
- If applicable, submit your Federal Controlled Substances Registration in Section D.
- For Section E, include your official transcripts from your podiatry education and details on your educational experience.
- In Section F, provide your examination information by submitting official score reports for your National Board Examination.
- Complete Section G by providing information about other licenses and any disciplinary actions related to those licenses.
- If you are applying by reciprocity, complete Section H by providing proof of practice in podiatry for at least three years.
- All applicants must complete Section I by stating whether they have practiced podiatry in Nebraska without a license.
- Finally, attest your application in Section J, ensuring all information is accurate before submitting.
- After filling out all sections, save your changes, and download or print the application for your records.
Complete your application online today to begin your journey towards a Podiatry License in Nebraska.
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