Get Rld Verification

Filling out the Rld Verification is an essential step for individuals seeking licensure to practice physical therapy in New Mexico. This guide will assist users in completing the form accurately and efficiently, ensuring that both applicants and employers understand their responsibilities.

Follow the steps to complete the Rld Verification online.

1. Click ‘Get Form’ button to obtain the Rld Verification form and open it in your editing tool.
2. Begin with Section A, labeled 'Applicant Information.' The applicant should fill out their last name, first name, mailing address, city, state, zip code, business or message phone, home phone, and print all other names used during employment.
3. Proceed to Section B, which is designated for employer information. The employer must input their name, mailing address, city, state, zip code, business or message phone, fax, and email address.
4. In Section B, provide the name of the applicant's supervisor at the time of employment, their title or position, the dates of employment including 'From' and 'To', and the reason for leaving employment.
5. Indicate whether the employer would rehire the applicant; if not, they should provide an explanation.
6. Employers must describe the duties performed by the applicant and confirm whether any complaints were filed against them. If there were complaints, an explanation should be included.
7. Additional comments may be added by the employer in the designated section.
8. The form must be signed by the employer in the presence of a notary public. Complete the Employer Certification by printing the name of the employer, their title, and obtaining their signature and date.
9. Lastly, the notary public will complete their section by signing and indicating the expiration date of their commission.
10. After completing the form, users can save changes, download, print, or share the Rld Verification form as needed.

Complete the necessary documents online to facilitate your licensure process.