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Polysomonographic Technologist - Application Wizard

Please choose one of the following:

I want to apply for a license to practice Polysomnographic Technology in Virginia

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.

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
  • An account of professional activity within the last two years, to include approximate number of hours for each year.
  • Evidence of completion of the continued competency requirements specified in Virginia regulations 18VAC85-140-70
  • Complete the reactivation application and send to the Board, along with applicable fee.

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 licenses from all jurisdictions 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.
  • NPDE 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.
  • Evidence of competency to return to active practice to include 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 and 12, 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
 

Virginia Board of Medicine
medbd@dhp.virginia.gov | Contact the Board
William L. Harp, MD, Executive Director
L. Blanton Marchese, President