TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
NOTICE: The following forms have been filed by the Board of Nursing. The forms are available for public inspection at the Board of Nursing, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, or at the Office of the Registrar of Regulations, General Assembly Building, 2nd Floor, Richmond, Virginia 23219. Copies of the forms may be obtained from Elaine Yeatts, Agency Regulatory Coordinator, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463.
Titles of Regulations: 18VAC90-20. Regulations Governing the Practice of Nursing.
18VAC90-25. Regulations Governing Certified Nurse Aides.
18VAC90-30. Regulations Governing the Licensure of Nurse Practitioners.
18VAC90-40. Regulations for Prescriptive Authority for Nurse Practitioners.
18VAC90-50. Regulations Governing the Certification of Massage Therapists.
18VAC90-60. Regulations Governing the Registration of Medication Aides.
FORMS (18VAC90-20)
Application for Licensure by Endorsement -- Registered Nurse (rev. 11/04) 1/08).
Instructions for Licensure by Endorsement -- Registered Nurse (rev. 12/04) 1/08).
Instructions for Licensure by Endorsement -- Licensed Practical Nurse (rev. 12/04) 1/08).
Application for Licensure by Endorsement -- Licensed Practical Nurse (rev. 11/04) 1/08).
Instructions for Filing Application for Licensure by Examination for Registered Nurses (rev. 12/04) 7/07).
Application for Licensure by Examination -- Registered Nurse (rev. 12/04) 7/07).
Instructions for Filing Application for Licensure by Examination for Practical Nurses (rev. 11/04) 7/07).
Application for Licensure by Examination -- Licensed Practical Nurse (rev. 12/04) 7/07).
Instructions for Filing Application for Licensure by Repeat Examination for Registered Nurses (rev. 6/04) 8/08).
Application for Licensure by Repeat Examination for Registered Nurse (rev. 10/02) 7/07).
Instructions for Filing Application for Licensure by Repeat Examination for Practical Nurses (rev. 2/03) 8/08).
Application for Licensure by Repeat Examination for Licensed Practical Nurse (rev. 10/02) 7/07).
Instructions for Filing Application for Licensure by Examination for Licensed Practical Nurses Educated in Other Countries (rev. 12/04) 7/07).
Application for Licensure by Examination for Licensed Practical Nurses Educated in Other Countries (rev. 12/04) 7/07).
Instructions for Filing Application for Licensure by Examination for Registered Nurses Educated in Other Countries (rev. 12/04) 7/07).
Application for Licensure by Examination for Registered Nurses Educated in Other Countries (rev. 12/04) 7/07).
Temporary Exemption to Licensure (eff. 10/02) (rev. 7/07).
Instructions for Application for Reinstatement -- Registered Nurse (eff. 12/04) (rev. 7/07).
Application for Reinstatement -- Registered Nurse (rev. 12/04) 7/07).
Instructions for Application for Reinstatement -- Licensed Practical Nurse (eff. 12/04) (rev. 7/07).
Application for Reinstatement of License as a Licensed Practical Nurse (rev. 12/04) 7/07).
Instructions for Application for Reinstatement Following Suspension or Revocation -- Registered Nurse (eff. 12/04) (rev. 7/07).
Application for Reinstatement of License as a Registered Nurse Following Suspension or Revocation (rev. 12/04) 7/07).
Instructions for Application for Reinstatement Following Suspension or Revocation -- Licensed Practical Nurse (eff. 12/04) (rev. 7/07).
Application for Reinstatement of License as a Licensed Practical Nurse Following Suspension or Revocation (rev. 12/04) 7/07).
License Verification Form (rev. 10/02) 1/08).
Renewal Notice and Application, 0001, RN (rev. 11/03).
Renewal Notice and Application, 0002, LPN (rev. 11/03).
Renewal Notice and Application, 0015, Clinical Nurse Specialist (rev. 12/02).
Application for Registration as a Clinical Nurse Specialist (rev. 10/02) 7/07).
Procedure for Registration as a Clinical Nurse Specialist (rev 7/07).
Survey Visit Report (rev. 12/02) 7/07).
Annual Report for Registered Nursing Programs (rev. 12/02).
Annual Report for Practical Nursing Programs (rev. 12/02).
Application for Registration for Volunteer Practice (eff. 12/02) (rev. 7/07).
Sponsor Certification for Volunteer Registration (eff. 1/03) (rev. 8/08).
FORMS (18VAC90-25)
Instructions for Application for Nurse Aide Certification by Endorsement (rev. 1/06 8/07).
Application for Nurse Aide Certification by Endorsement (rev. 8/06 8/07).
Nurse Aide Certification Verification Form (rev. 12/02 11/07).
Instructions for Applicant for Advanced Certified Nurse Aide Registration (eff. 8/06 rev. 8/07).
Application for Certification as Advanced Certified Nurse Aide (rev. 8/06 8/07).
Instructions for Application for Reinstatement of Nurse Aide Certification (rev. 8/06 1/08).
Application for Reinstatement of Nurse Aide Certification (rev. 8/06 1/08).
Instructions for Application for Reinstatement of Advanced Nurse Aide Certification (eff. 2/03 rev. 8/07).
Application for Reinstatement of Advanced Nurse Aide Certification (eff. 2/03 rev. 8/07).
Application to Establish Nurse Aide Education Program (rev. 12/02 8/07).
Application to Establish an Advanced Certification Nurse Aide Education Program (eff. 12/02 rev. 8/07).
Nurse Aide Education Program Evaluation Report (rev. 11/02 8/07).
Nurse Aide Education Program-On-site Review Report (rev. 11/02 8/07).
Advanced Certification Nurse Aide Education Program Evaluation Report (rev. 8/08).
Advanced Certification Nurse Aide Education Program-On-site Review Report (eff. 12/02 rev. 8/07).
Evaluation of On-Site Visitor (rev. 12/02).
Request for Statistical Information (rev. 12/02 6/08).
Renewal Notice (eff. 4/05).
Renewal Notice and Application, 1401, Certified Nurse Aide (rev. 12/02).
Renewal Notice and Application, Advanced Certified Nurse Aide (eff. 12/02).
FORMS (18VAC90-30)
Instructions for Licensure -- Nurse Practitioner (rev. 10/02 1/08).
Application for Licensure as a Nurse Practitioner (rev. 10/02 1/08).
Renewal Notice and Application, Nurse Practitioner, 0024 (rev. 1/03).
Application for Reinstatement of License as a Nurse Practitioner (eff. 10/02 rev. 7/07).
License Verification Form (rev. 7/07).
FORMS (18VAC90-40)
Application for Prescriptive Authority for Licensed Nurse Practitioners (rev. 10/02 7/07).
Prescriptive Authority for Licensed Nurse Practitioners Practice Agreement (rev. 10/02 7/07).
License Renewal Notice and Application (rev. 2002).
Application for Reinstatement of Prescriptive Authority (rev. 7/07).
FORMS (18 VAC 90-50)
Instructions for Filing Application for Certification as a Massage Therapist (rev. 10/02 7/07).
Application for Certification -- Massage Therapist (rev. 10/02 7/07).
Instructions for Filing Application for Certification as a Massage Therapist by Endorsement (rev. 10/02 7/07).
Application for Certification by Endorsement -- Massage Therapist (rev. 10/02 7/07).
Massage Therapist Certification/Licensure Verification Form (rev. 10/02 7/07).
Application for Reinstatement of Certificate as a Massage Therapist (rev. 10/02 7/07).
Renewal Notice and Application (rev. 6/02).
Instructions for Application for Reinstatement following Suspension or Revocation – Certified Massage Therapist (rev. 7/07).
Application for Reinstatement of Certificate as a Massage Therapist following Suspension or Revocation (rev. 7/07).
FORMS (18VAC90-60)
Application to Establish a Medication Aide Training Program (eff. 7/07).
Instructions for Filing Application for Registration by Examination for Medication Aides (eff. 7/07).
Application for Registration by Examination for Medication Aide (eff. 7/07).
Instructions for Filing Application for Reinstatement as a Medication Aide (eff. 7/07).
Application for Reinstatement of Medication Aide Registration (eff. 7/07).
Application for Registration by Repeat Examination for Medication Aide (eff. 8/08).