REGULATIONS
Vol. 37 Iss. 25 - August 02, 2021

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF FUNERAL DIRECTORS AND EMBALMERS
Chapter 20
Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Titles of Regulations: 18VAC65-20. Regulations Governing the Practice of Funeral Services.

18VAC65-40. Regulations for the Funeral Service Internship Program.

Agency Contact: Elaine Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive Suite 300, Henrico, VA 23233, telephone (804) 367-4688, FAX (804) 527-4434, or email elaine.yeatts@dhp.virginia.gov.

FORMS (18VAC65-20)

Continuing Education Provider Renewal Form (rev. 3/2018)

Checklist and Instructions for Funeral Service Licensee (rev. 7/2020)

Funeral Service License Reinstatement Application (rev. 7/2020)

Checklist and Instructions for Funeral License (rev. 7/2021)

Funeral Service Licensee Reinstatement Application (rev. 7/2021)

Request for Verification of a Virginia Funeral License (rev. 11/2019)

Checklist and Instructions for Courtesy Card Application (rev. 8/2020)

Checklist and Instructions for Surface Transportation and Removal Service Registration Application (rev. 7/2020)

Checklist and Instructions for Crematory Registration Application (rev. 7/2020)

Checklist and Instructions for Continuing Education Providers (rev. 7/2020)

Checklist and Instructions for Courtesy Card Application (rev. 7/2021)

Checklist and Instructions for Surface Transportation and Removal Service Registration Application (rev. 7/2021)

Checklist and Instructions for Crematory Registration Application (rev. 1/2021)

Checklist and Instructions for Continuing Education Providers (rev. 3/2021)

Instructions for Completing the Continuing Education Summary Form for The Virginia Board of Funeral Directors and Embalmers (rev. 8/2016)

Instructions for Continuing Education Providers Adding Additional Courses (rev. 3/2018)

Instructions for Continuing Education Providers Adding Additional Courses (rev. 3/2021)

Continuing Education (CE) Credit Form for Volunteer Practice (rev. 7/2020)

Continued Competency Activity and Assessment Form (rev. 7/2012)

Funeral Service New Establishment Application (rev. 7/2020)

Funeral Service Establishment/Branch Application (rev. 7/2020)

Funeral Service Establishment/Branch Change Application (rev. 7/2020)

Funeral Establishment or Branch Change of Manager Application (rev. 3/2018)

Funeral Service New Establishment Application (rev. 7/2021)

Funeral Service Establishment/Branch Application (rev. 7/2021)

Funeral Service Branch Establishment Application (rev. 7/2021)

Funeral Service Establishment/Branch Change Application (rev. 7/2021)

Funeral Establishment or Branch Change of Manager Application (rev. 7/2021)

Request for Reinspection due to Structural Change to Preparation Room (rev. 7/2020)

Waiver of Full-Time Manager (rev. 7/2020)

Funeral Service Establishment Reinstatement Application (rev. 7/2020)

Courtesy Card Reinstatement Application (rev. 7/2020)

Waiver of Full-Time Manager (rev. 7/2021)

Funeral Service Establishment Reinstatement Application (rev. 7/2021)

Courtesy Card Reinstatement Application (rev. 7/2021)

Presentation Request Form (rev. 7/2020)

Name/Address Change Form (rev. 2/2016)

Appendix I. General Price List (rev. 10/2019)

Appendix II. Casket Price List, Outer Burial Container Price List (rev. 10/2019)

Appendix III. Itemized Statement of Funeral Goods and Services Selected (rev. 10/2019)

FORMS (18VAC65-40)

Application for Funeral Service Internship Program, online form available at https://www/license/dhp.virginia.gov/apply/

Funeral Supervisor Registration Application (rev. 2/2021)

Funeral Change of Supervisor Application (rev. 2/2021)

Funeral Supervisor Registration Application (rev. 7/2021)

Funeral Change of Supervisor Application (rev. 7/2021)

Checklist and Instructions for Registration for Funeral Service Internship Program (rev. 7/2021)

Checklist and Instructions for Registration for Funeral Directing Internship Program (rev. 7/2021)

Checklist and Instructions for Registration for Embalming Internship Program (rev. 7/2021)

First 1000 Hour Funeral Service Internship Report – Funeral Directing (rev.1/2021)

Second 1000 Hour Funeral Service Internship Report – Funeral Directing (rev. 1/2021)

Funeral Service Internship Report of Final Completion – Funeral Directing (rev. 1/2021)

First 1000 Hour Embalming Internship Report (rev. 1/2021)

Second 1000 Hour Embalming Internship Report (rev. 1/2021)

Embalming Internship Report of Final Completion (rev. 1/2021)

Funeral Intern Reinstatement Application (rev. 7/2021)

VA.R. Doc. No. R21-6761; Filed July 04, 2021