Virginia Board of Medicine

Please choose one of the following:

I am a new graduate /trainee and want to apply for a full Polysomnographic Technologist license

I have previously been issued a license/certification/registration/permit or other form of authorization to practice as a Polysomnographic Technologist in the United States or Canada

I want to reactivate a Current Inactive Status Polysomnographic Technologist license

I want to reinstate my lapsed or expired Polysomnographic Technologist License

What you'll need in order to apply:

Review the full set of Laws and Regulations regarding the practice of Polysomnographic Technology in the state of Virginia
Carefully read through the application instructions
Credential Verification (of one of the following): Contact the certifying body and have them send the document directly to the Board.
- Current certification as a Registered Polysomnographic Technologist (RPSGT) by the Board of Registered Polysomnographic Technologists;
- Documentation of the Sleep Disorders Specialist credential from the National Board of Respiratory Care (NBRC-SDS); or
- A professional certification or credential approved by the board from an organization or entity which is a member of the National Organization for Competency Assurance.
Basic Cardiac Life Support Provide Documentation of current certification in Basic Cardiac Life. The Board will accept a notarized copy of this document from the applicant.

Applicants licensed in another state/jurisdiction:

NPDB Self-Query: Complete the online Place a Self-Query Order form and verify your identity.
License Verification: Please contact the applicable jurisdiction where you have been issued a license to practice
to inquire about having documentation forwarded to the Virginia Board of Medicine.

Reactivate a Current Inactive status License

The Inactive to Active application is for licenses that are currently in a Current Inactive status. If you want to return to a Current Active status, contact the Board at 804-367-4600, Option 2 for an application.
If your license has been in an expired status for less than two-years, you are able to renew it using your established login credentials here. If you need assistance with your login credentials, contact our HelpDesk at 804-367-4444.
If your license has been in an expired status for more than two-years, will need to apply using the reinstatement application for your profession.

Do not complete this application if your license has been expired for less than 2 years or if you are trying to reactivate a license in inactive status.

This application is a PDF form that will need to be printed, filled out and sent to:

Virginia Board of Medicine
Perimeter Center
9960 Mayland Drive, Suite 300
Henrico, Virginia 23233-1463

What you'll need in order to apply:

Review the full set of Laws and Regulations regarding the practice of Polysomnographic Technology in the state of Virginia
Carefully read through the application instructions
Verification of professional license from one jurisdiction within the United States, its territories and possessions or Canada in which you have been issued a full license must be received by the Board.
NPDB Self Query – Complete the online “Place a Self-Query” Order form.
Evidence of competency to return to active practice to include an attestation of current certification in Basic Life Support for health care providers and one of the following:
- Information on continued active practice in another jurisdiction during the period in which the license has been inactive or lapsed;
- Attestation of at least 10 hours of continuing education for each year in which the license has been inactive or lapsed, not to exceed three years; or
- Recertification by passage of an examination for the Registered Polysomnographic Technologist (RPSGT), the Sleep Disorders Specialist credential from the National Board of Respiratory Care (NBRC-SDS), or other credential approved by the board for initial licensure.
Provide copies of documentation supporting any name change since your initial license was granted in Virginia
If you have entered an answer on any questions between 5-14 and 16-17, provide documentation to the Board from your attorney, or you may provide a narrative, explaining your answer. Please provide court documentation for any convictions.
Fill out the Reinstatement application for a Polysomnographic Technologist license and send to the Board, along with any applicable fees.

Please choose one of the following:

I have never practiced this profession, and do not hold an existing license in another jurisdiction

I have previously practiced this profession, and/or hold an existing license in another jurisdiction

What you'll need in order to apply:

Review the full set of Laws and Regulations regarding the practice of Polysomnographic Technology in the state of Virginia
Carefully read through the application instructions
NPDB Self Query – Complete the online "Place a Self-Query" Order form
Verify your identity. This can be done electronically as part of your "Place a Self-Query" order or by completing a paper form and having it notarized.
Verification of licenses to practice as a Respiratory Therapist from all jurisdictions within the United States, its territories and possessions or Canada in which you have been issued a license must be received by the Board. Please contact the applicable jurisdiction where you have been issued a license to practice respiratory therapy to inquire about having documentation forwarded to the Virginia Board of Medicine.
Credential Verification (of one of the following). Contact the certifying body and have them send the document directly to the Board.
- Current certification as a Registered Polysomnographic Technologist (RPSGT) by the Board of Registered Polysomnographic Technologists;
- Documentation of the Sleep Disorders Specialist credential from the National Board of Respiratory Care (NBRC-SDS); or
- A professional certification or credential approved by the board from an organization or entity which is a member of the National Organization for Competency Assurance.
Documentation of current certification in Basic Cardiac Life
A completed Form B or a letter of recommendation must be received from all locations of service, places of practice or professional employment, observerships, professional research positions or professional volunteer service listed for the 2 years immediately preceding application.o A completed Form B Activity Questionnaire or a letter of recommendation must be received from all locations of service, places of practice or professional employment, observerships, professional research positions or professional volunteer service listed for the 2 years immediately preceding application.
For applicants practicing as travelers, have the company you are affiliated with provide a complete list of all locations and dates where you have provided service. Form B must be received from each location of service for the past 2 years

Please choose one of the following:

My Polysomnographic Technologist license/certification/registration/permit in the United States or Canada is in good standing, defined as current and unrestricted, or if lapsed, eligible for renewal or reinstatement.

Yes

Do you currently hold current certification by one of the following?

The Registered Polysomnographic Technologist (RPSGT) credential by the Board of Registered Polysomnographic Technologists (BRPT)
The Sleep Disorders Specialist credential from the National Board of Respiratory Care (NBRC-SDS)
Professional certification or credential in sleep studies from an organization or entity that meets the accreditation standards of the Institute for Credentialing Excellence

Yes

I hold current certification in Basic Life Support for Health Care Providers with a hands-on practice training evaluation segment.

Yes

Do any of the following apply to you?

Denial of license or privilege of taking a licensure/competency exam by any testing entity or licensing authority
Conviction of a violation of local, state or federal statute, regulation or ordinance, or entrance into any plea agreement relating to a felony or misdemeanor. (Exclude traffic violations, except convictions for DUI and reckless driving)
Denial or voluntary surrender of clinical privileges for any reason
Placement on a corrective action plan, placement on probation or dismissal or suspension or request to withdraw from any professional school, training program, hospital, etc.
Termination from employment or resignation in lieu of termination from any training program, hospital, healthcare facility, healthcare provider, provider network or malpractice insurance carrier
Pending or past disciplinary action against your professional license/certification/permit/registration related to your practice of medicine
Voluntary withdrawal from any professional society while under investigation
Malpractice suits brought against you in the past ten (10) years

No, none of the above apply to me

Yes, one or more of the above apply to me

Licensure by Endorsement

You have indicated that you meet the criteria to apply for licensure by Endorsement

What you'll need in order to apply:

Application and Fee Payment
Employment Chronology
Professional License Verification
NPDB Self-Query
Current certification in Basic Life Support for Health Care Providers with a hands-on practice training evaluation segment.

To facilitate your license application process, please carefully review the Laws and Regulations that govern the practice of behavior analysis in Virginia along with the Application Instructions and Checklist to ensure you have all necessary documents before starting your application.

Click the Apply Now button below to begin the online application process.

Mailing Address:
Virginia Board of Medicine
c/o Polysomnographic Technologist Licensing
9960 Mayland Drive, Suite 300
Henrico, VA 23233-1463

Polysomonographic Technologist - Application Wizard

Reactivate a Current Inactive status License

Licensure by Endorsement