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Forms

Please select a profession or category from the dropdown, to view related forms.

Initial applications for Certified Nurse Aide by Endorsement are accepted exclusively online.

Initial applications for Certified Nurse Aide by Examination in Virginia are processed through the testing service - Pearson VUE.  Please click here to link to Pearson VUE's website for information and an application to sit for the Virginia Nurse Aide Competency Test ("State Board").

If you are unsure of how to apply, please see our Application Wizard for guidance.

Initial applications for Advanced Certified Nurse Aide certification are accepted exclusively online.  To qualify for an Advanced Certification, you must hold a current Nurse Aide certification in Virginia.

Reinstatement Applications

CNA Reinstatement Application and Instructions

Advanced CNA Reinstatement Application and Instructions

Initial applications for registration as a Clinical Nurse Specialist (CNS) are accepted exclusively online.  Before begining an application, please see our Application Wizard for details.

Checklist Instructions for Clinical Nurse Specialist Registration

Reinstatement Application

Instructions and Application for Reinstatement of Registration as a CNS

Please use our Application Wizard for guidance on how to apply for initial licensure as a Practical Nurse.

Applications for initial licensure as a Practical Nurse by Endorsement or Examination are accepted exclusively through our online system.

Licensure by Endorsement

Endorsement Application Instructions

Verification - Non-NURSYS Participating States

Licensure by Examination

Examination Application Instructions

Licensure by Repeat Examination

 Application and Instructions for Licensure by Repeat Examination

Reinstatement

RN-LPN Reinstatement Application

RN-LPN Reinstatement Application following Suspension or Revocation

Reactivation

Inactive to Active Request Form (RN and LPN)

Nurse Licensure Compact

Declaration of Primary State of Residence Form

Please use our Application Wizard for guidance on how to apply for initial licensure as a Registered Nurse.

Applications for initial licensure as a Registered Nurse by Endorsement or Examination are accepted exclusively through our online system.

Licensure by Endorsement

Endorsement Application Instructions

Verification - Non-NURSYS Participating States

Licensure by Examination

Examination Application Instructions

Licensure by Repeat Examination

 Application and Instructions for Licensure by Repeat Examination

Reinstatement

RN-LPN Reinstatement Application

RN-LPN Reinstatement Application following Suspension or Revocation

Reactivation

Inactive to Active Request Form (RN and LPN)

Nurse Licensure Compact

Declaration of Primary State of Residence Form

Please use our Application Wizard for guidance on how to apply for initial licensure as a Nurse Practitioner.

Applications for initial licensure as a Nurse Practitioner are accepted exclusively online.

NOTE:  If you already have a Nurse Practitioner license and you wish to add additional specialties, you will need to contact the Board of Nursing at (804) 367-4515 to have a paper Application for Licensure as a License Nurse Practitioner mailed to you.  You cannot use the online nurse practitioner application process to apply for additional specialties.

Application Instructions for Licensure - Nurse Practitioner

Verification Form - Nurse Practitioner (this form is required ONLY for applicants who have been licensed as a nurse practitioner in another state/jurisdiction)

Autonomous Practice

Autonomous Practice Application - Nurse Practitioners with the equivalent of 5 years of full-time clinical experience may apply for full practice authority. 

Reinstatement Forms

Instructions and Application for Reinstatement of License as a Nurse Practitioner

Instructions and Application for Reinstatement of License as a Nurse Practitioner following Suspension or Revocation

 

Please use our Application Wizard for guidance on initial application for Prescriptive Authority/Authorization to Prescribe.

Initial applications for Prescriptive Authority are accepted exclusively online.

NOTE: You will also need to submit an application for a Nurse Practitioner License, or already hold a current Nurse Practitioner License in order to apply for Authorization to Prescribe (Prescriptive Authority)

Checklist Instructions for Prescriptive Authority for Licensed Nurse Practitioners

Reinstatement Forms

Instructions and Application for Reinstatement of Prescriptive Authority

Instructions and Application for Reinstatement of Prescriptive Authority following Suspension or Revocation

 

Please use our Application Wizard for guidance on how to apply for a license as a Massage Therapist

Applications for licensure as a Massage Therapist are accepted exclusively through our online system.

Endorsement
Checklist Instructions for Licensure by Endorsement as a Massage Therapist
Verification Form - Massage Therapist (form required for applicants applying to Virginia who have been licensed/certified/ registered as a massage therapist in another state/jurisdiction)

Initial Licensure
Checklist Instructions for Initial Licensure as a Massage Therapist

Reinstatement
Checklist Instructions and Application for Reinstatement as a Massage Therapist

Checklist Instructions and Application for Reinstatement as a Massage Therapist following Suspension or Revocation

Please use our Application Wizard to help determine how to apply for initial registration as a Medication Aide

Applications for initial registration as a Medication Aide by Examination or Endorsement are accepted exclusively through our online system.

Candidate Information Bulletin from PSI

Reinstatement Application Forms

Instructions for Filing a Medication Aide Reinstatement Application

Application for Reinstatement of Medication Aide Registration

Note: You are not required to file a volunteer practice registration application if you hold a current unrestricted license or a multi-state privilege to practice nursing in Virginia.

Instructions and Application for Registration for Volunteer Nursing Practice

Volunteer Practice Sponsor Form

Click here to view applicable nursing regulation 18 VAC 90-19-200

Instructions and Application for Restricted Volunteer Nursing License

Click here to view § 54.1-3011.01. Restricted volunteer license for registered or practical nurses

Click here to view § 54.1-2957.001. Restricted volunteer license for nurse practitioners

Request Form for Change of Status from Inactive to Active (Registered or Practical Nurses)

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

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

Name Change Information

All licensees/applicants wishing to change their name with the Board must submit their request using the Nursing Name Change Form. Follow the instructions on the form when the required information is submitted.

Pursuant to 18 VAC 90-19-50 (B) a copy of one of the following documents must accompany a name change request:
 • Marriage Certificate
 • Certificate of Naturalization
 • Court Order

Virginia Board of Nursing
Jay P. Douglas, MSM, RN, CSAC, FRE, Executive Director
Louise Hershkowitz. CRNA, MSHA, President