Get Nv Perfusionist Application Checklist 2013

Filling out the NV Perfusionist Application Checklist is an essential step for individuals seeking licensure as a perfusionist in Nevada. This guide provides a step-by-step approach to navigating each section of the checklist, ensuring that all necessary components are accurately completed for successful submission.

Follow the steps to complete the NV Perfusionist Application Checklist online.

1. Click the ‘Get Form’ button to obtain the NV Perfusionist Application Checklist and open it in your preferred editing tool.
2. Begin with the application section, ensuring that the application is properly completed, signed, and notarized. Attach all required documents, including the applicant responsibility statement and criminal background investigation report authorization form.
3. Attach a recent passport quality photograph (at least 2” x 2”). Make sure to sign in ink on the lower front edge of the photograph.
4. For any affirmative responses to specific questions (8, 9, 10, etc.), provide appropriate explanations and documentation as required.
5. Ensure that all applicable fees are paid. Indicate the method of payment — cashier's check, money order, or credit card — and attach the corresponding authorization form when relevant.
6. For identity verification, submit the required documents based on your citizenship status, ensuring that originals or certified copies are included.
7. Get the self-query verification report from the National Practitioner Data Bank and attach it to your application. Follow the enclosed instructions to request this report.
8. If applicable, complete and attach the malpractice insurance carrier form, ensuring those who have answered affirmatively to the related questions include the necessary details.
9. Collect and attach education documents such as high school transcripts or relevant diplomas. Verify that all supporting educational materials are correctly listed.
10. Complete the notification forms for practice location and supervising perfusionists as required. Sign and date these forms appropriately.
11. Review the continuing education requirements, ensuring that you attest to having reviewed guidelines from the Centers for Disease Control and Prevention.
12. Finally, review all completed sections for accuracy, save changes, and prepare to download, print, and share the application as necessary.

Begin your application process online today to create a successful NV Perfusionist licensure application.