Get Mbon

Filling out the Mbon, or Nurse Practitioner Attestation Form, is an essential step for nurse practitioners in Maryland to ensure compliance with state regulations. This guide will provide you with clear and detailed instructions on how to complete the form accurately and efficiently.

Follow the steps to accurately complete the Mbon online.

1. Click 'Get Form' button to obtain the form and access it in your preferred editor.
2. Enter your name as it appears on your nursing license in the designated field.
3. Provide your home address, including the city, state, and zip code, in the appropriate fields.
4. Fill in your home phone number, office phone number, and cell phone or pager number as required.
5. Input your email address in the prescribed field for communication purposes.
6. Choose all applicable certifications from the list provided, ensuring you select the appropriate types that apply to your qualifications.
7. Enter your Maryland RN or AC License number in the specified section.
8. Identify and type the name and license number of your Maryland licensed physician collaborator in the next fields, noting that only one collaborator is necessary.
9. Type your name at the declaration section affirming the accuracy of the information you have provided.
10. Sign the form with your original handwritten signature and include the date of signing.
11. Once completed, save a copy of your filled-out form to your computer for your records before mailing the signed version to the Board.

Complete the Mbon online today to ensure your compliance with the Maryland Board of Nursing.