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The University of the State of New York The State Education Department Office of the Professions Division of Professional Licensing Services www.op.nysed.govClinical Laboratory Technologist Form 4PP Certification.

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How to fill out the NY Form 4PP online

This guide provides you with comprehensive and user-friendly instructions on how to complete the New York Form 4PP online. Designed for applicants seeking certification as a clinical laboratory technologist, this guide will walk you through each section of the form.

Follow the steps to complete the NY Form 4PP online.

  1. Press the ‘Get Form’ button to access the form and open it in your preferred online environment.
  2. Begin with Section I, where you will need to provide your personal information. Fill in your Social Security Number, birth date, full name, telephone, and email address. Be sure to indicate if your mailing address is your home or business address.
  3. In Section I, you must also include your New York State DMV ID number if applicable. List the name of the Clinical Laboratory Director or Principal Researcher you are requesting to complete this form.
  4. Check all applicable training areas from the list provided in Section I. For each area where you received training, enter the total hours completed.
  5. Document your duration of training or experience by providing starting and ending dates, along with total clock hours for the entire training period.
  6. At the end of Section I, ensure that you provide your signature and the date, confirming the accuracy of the information provided.
  7. Forward the entire form to the Clinical Laboratory Director or Principal Researcher to complete Section II, which requires their affirmation and signature.
  8. In Section II, the Clinical Laboratory Director or Principal Researcher will confirm their qualifications and the applicant's training experience. They should provide necessary details and affirmation by signature.
  9. Once all sections are completed, the Clinical Laboratory Director or Principal Researcher must send the entire form directly to the Office of the Professions at the specified address.
  10. Finally, save any changes you made to the form, and download or print a copy for your records before it is submitted.

Complete your NY Form 4PP online today to ensure a seamless certification process.

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NY Form 4PP
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