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Virginia Board of Nursing
Forms

 

The below documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer 97/2000 to view and print DHP's documents.

Licensed Practical Nurse

Application and Instructions for Licensure by Endorsement as a Practical Nurse (includes form for Verification of Licensure or Registration)

Please Note: Click here to determine if your original state of Licensure requires the Nursys form for verification.  Click here to download the verification form from Nursys. (PDF file).  Click here to use the Nursys online verification system.

Licensure by Examination - Practical Nurse

Application and Instructions for Licensure by Examination as a Practical Nurse

To obtain information regarding the NCLEX Examination, please visit the Pearson VUE website at www.vue.com

Application and Instructions for Licensure by Examination for LPN's Educated in Other Countries

Licensure by Repeat Examination - Practical Nurse

Application and Instructions for Licensure by Repeat Examination as a Practical Nurse

To obtain information regarding the NCLEX Examination, please visit the Pearson VUE website at www.vue.com

Reinstatement Applications - Practical Nurse

Application and Instructions for Reinstatement of License as an LPN

Application and Instructions for Reinstatement of License as an LPN Following Suspension or Revocation

Declaration of Primary State of Residence Form

Registered Nurse

Application and Instructions for Licensure by Endorsement - Registered Nurse (includes form for Verification of Licensure or Registration)

Please Note: Click here to determine if your original state of Licensure requires the Nursys form for verification.  Click here to download the verification form from Nursys. (PDF file).  Click here to use the Nursys online verification system.

Licensure by Examination - Registered Nurse

Application and Instructions for Licensure by Examination as a Registered Nurse

To obtain information regarding the NCLEX Examination, please visit the Pearson VUE website at www.vue.com

Application and Instructions for Licensure by Examination for Registered Nurses Educated in Other Countries

Licensure by Repeat Examination -  Registered Nurse

Application and Instructions for Licensure by Repeat Examination as a Registered Nurse

To obtain information regarding the NCLEX Examination, please visit the Pearson VUE website at www.vue.com

Reinstatement Applications - Registered Nurse

Application and Instructions for Reinstatement of License as a Registered Nurse

Application and Instructions for Reinstatement of License as a Registered Nurse Following Suspension or Revocation

Declaration of Primary State of Residence Form

 

Clinical Nurse Specialist

Application and Instructions for Registration as a Clinical Nurse Specialist

Application for Reinstatement of Registration as a Clinical Nurse Specialist

 

Nurse Practitioner

Application and Instructions for Licensure as a Nurse Practitioner

Verification Form

Application and Instructions for Prescriptive Authority for Licensed Nurse Practitioners

Memo on Expanded Prescriptive Authority

Prescriptive Authority for Licensed Nurse Practitioners - Practice Agreement

Application for Reinstatement of License as a Nurse Practitioners

Application for Reinstatement of Prescriptive Authority

 

Massage Therapist

Application and Instructions for Certification as a Massage Therapist by Examination

Application and Instructions for Certification as a Massage Therapist by Endorsement

Application for Reinstatement of Certificate as a Massage Therapist, rev. 2/2005.

 

Certified Nurse Aide

(NNAAP) Click here to link to Promissor’s website for information and an application to sit for the state Nurse Aide exam

Application and Instructions for CNA by Endorsement

CNA Reinstatement Application and Instructions

Application and Instructions for Certification as an Advanced Certified Nurse Aide

Application and Instructions for Reinstatement of Advanced Nurse Aide Certification

 

Medication Aide

Application to Establish a Medication Aide Training Program

Instructions for Filing an Application for Registration by Examination for Mediation Aides

Application for Registration as a Medication Aide

Candidate Information Bulletin

Instructions for Fililng an Application for Reinstatement as a Medication Aide

Application for Reinstatement of Medication Aide Registration

 

Volunteer Practice Forms

Volunteer Practice Sponsor Form

Application for Registration for Volunteer Practice

 

Nursing Education Program

Application to Establish a Nursing Education Program

 

Survey Visit Report Forms for Education Programs

Survey Visit Report Form and Agenda for Registered Nurse Education Programs

Survey Visit Report Form and Agenda for Licensed Practical Nurse Education Programs