916-263-7800 Fax 916-263-7855 www.bvnpt.ca.gov APPLICATION FOR REPLACEMENT PT LICENSE The Board of Vocational Nursing and Psychiatric Technicians acknowledges receipt of your request for a replacement license. Please follow the instructions below to obtain a replacement license: Complete this form and attach a check or money order for $20.00 made payable to the BVNPT. Mail the form and check to the Board at the address shown above. Please allow 3-4 weeks for processing.
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How to fill out the CA 55CP-4 online
Filling out the CA 55CP-4 form for a replacement license can be a straightforward process if you understand each section of the form. This guide will walk you through the steps needed to complete the form online confidently.
Follow the steps to complete your CA 55CP-4 form online.
- Press the ‘Get Form’ button to retrieve the CA 55CP-4 form and open it in the online editor.
- Begin filling out the form by entering your last name, first name, and middle name in the designated fields.
- Input your PT license number, date of birth, and social security number in the corresponding fields.
- Provide your address, including street or PO box number, city, state, and zip code.
- Enter your business and home telephone numbers with the appropriate area codes.
- Indicate if this is a name change or address change by selecting 'Yes' or 'No.' Remember that a name change must be accompanied by documentation.
- Complete Section A or B based on your situation. If applicable, check for damaged or lost/stolen statuses and provide the circumstances surrounding the loss or theft.
- Carefully read the certification statement and affirm your understanding by signing the form and dating it.
- Once completed, save your changes, and review the form for accuracy. You can then download, print, or share your completed CA 55CP-4 form.
Complete your CA 55CP-4 form online today to ensure a swift replacement of your license.
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