Get Wv Dhhr Form Cltl-103

Filling out the WV DHHR Form CLTL-103 online is an essential step for individuals seeking licensure as clinical laboratory practitioners in West Virginia. This guide will provide clear and supportive instructions to ensure the process is straightforward and accessible.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin with the identification, mailing, and personal data section. Enter your full name, including maiden name if applicable, and provide a complete mailing address with the appropriate zip code.
3. For the present employer section, write the name of your workplace and its full mailing address and telephone number.
4. In the employment work arrangements section, indicate whether you are employed full time, part time, or not currently employed.
5. For the complexity of testing, check all appropriate options that apply to your current position.
6. In the position currently held section, check all the positions you are currently performing in the laboratory.
7. Complete the education, training, certification, and experience data thoroughly, ensuring all institutions and qualifications are documented.
8. In the certification section, check all applicable qualifications and provide details as required.
9. If applicable, have your laboratory director complete the verification of competency section by confirming your training and skills.
10. After completing all relevant sections, ensure to sign the necessary fields designated for both the applicant and the laboratory director.
11. Finally, remember to save your changes, download, print, or share the completed form as required.

Take the next step in your professional journey by completing the WV DHHR Form CLTL-103 online today.