Skip to Content
Online Services | Agencies | Governor | Help
Search Virginia.Gov

Board of Long-Term Care Administrators
Forms & Applications

The below documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer to view and print DHP's documents.

Nursing Home Administrator Forms:

General Information

Application for Licensure by Endorsement

Application for Initial Licensure

Application for Administrator-In-Training

Application for Registration/Reinstatement as a Preceptor

Application for Reinstatement

National Association of Boards of Examiners of Long-Term Care Administrators (NAB)

Continuing Competency

 

Assisted Living Facility Administrator Forms:

ALF-AIT Education and Experience Matrix

ALA Application for Licensure by Education

ALA Application for Licensure by Endorsement or Credentials

ALA Application for Reinstatement

ALA Application for Administrator-in-Training

ALA Application for an “Acting” Administrator-in-Training

ALA Application for Certification/Reinstatement as a ALA Preceptor

Continuing Competency