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Advanced Practice Forms


The online process to apply for an APRN license is active. Please access Online Services to submit an application online.

Advanced Practice Licensure Packets

Application Packet for Advanced Practice Licensure

Advanced Practice Licensure Individual Forms

Application Instruction Page

Application for Advanced Practice Registered Nurse Licensure

Confirmation of Program Completion for Advanced Practice Registered Nurse

Post-Graduate Practice Verification Form

Confirmation of Advanced Practice Registered Nurse Employment

Application for Continued Authority to Practice after Certification on File Expires Forms

Application for Continued Authority to Practice Instruction Page

Application for Continued Authority to Practice

Confirmation of Advanced Practice Registered Nurse Employment

Reorientation Forms

Reorientation Plan Information

Statement of Intent to Practice in a Reorientation Plan

Affidavit of Successful Completion of Reorientation Plan

Reregistration Forms

Reregistration Instructions

Application for Reregistration

Confirmation of Advanced Practice Registered Nurse Employment

Other Forms

APRN Dispensing for Profit Form
This statement must be filed with the Board if an APRN is dispensing drugs for profit. This law refers only to drugs that are 1) to be administered orally; 2) ordinarily dispensed by pharmacists; and 3) not vaccines.

Document Replacement Request

Name, Address, Phone Number, Change Request

Verification of CRNA Written Prescribing Agreement for Purposes of Providing Non-Surgical Pain Therapies for Chronic Pain Symptoms Form

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