Licensing Documents & Forms
Below is a listing of documents and forms pernentant to licensure and registration.
| Title | Content | Link |
|---|---|---|
| Criminal History Record Check Checklist | A helpful checklist of items to review in order to avoid having your criminal history record check packet rejected. | |
| SFN 17706 – Verification of Employment | This employment verification will be used to determine eligibility for license/renewal. | |
| SFN 19800 – Request for Testing Accommodations | A request form for those needing disability/testing accomidations for taking the NCLEX. | |
| SFN 52754 – Verification of Practice | This form is to indicate/record practice hours for your profession. | |
| SFN 53337 – Verification of Eligibility for Medication Assistant | Verification of Eligibility form for Medication Assistants (students in a nursing education program). | |
| SFN 60216 – Verification of Enrollment – UAP/Technician | This form is for indivdiuals currently enrolled in a Dialysis, Surgical, Medical Assistant program or for those enrolled Nursing School Program. | |
| SFN 60688 & 62550 – CHRC | Criminal History Record Check Request Form and Fingerprint Identificaton Form (January 2025) |
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Page Last Modified: March 13, 2025
