Board of Nursing: LPN Applications and Forms Documents

Licensed Practical Nurse (PN) Applications

Licensure

• Licensed Practical Nurse - Original License by Examination or Endorsement (Apply Online)
  • Online Exam/Endorsement Application Checklist
• Licensed Practical Nurse - Reinstate Expired License (Apply Online)
  • PN Reinstatement Application Checklist
• Licensed Practical Nurse - Reactivate Inactive License
• Licensed Practical Nurse - Change Status to Inactive
• Licensed Practical Nurse - Change Status to Volunteer

IV Authority

• Licensed Practical Nurse - IV or Compact IV Authority (Apply Online)
  • IV Authority - Online Application Checklist
• Licensed Practical Nurse - Reinstate IV or Compact IV Authority (Apply Online)
  • IV Authority - Online Reinstatement Application Checklist

Additional Applications, Forms & Checklists

• Licensed Practical Nurse - Original (Non-NURSYS Participating States) Verification
• Licensed Practical Nurse - Competency to Practice Form
• IV Authority - Competency Checklist
• Licensed Practical Nurse - Declaration of Primary State of Residence
• Licensed Practical Nurse - Special or Student Permit Application
• Test Accommodation Request Form