Instructions For Applying For Multistate Licensure For . - Oklahoma

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Oklahoma Board of Nursing2501 N. Lincoln Blvd., Suite 207Oklahoma City, OK 73105(405) 962-1800www.nursing.ok.govInstructions for Applyingfor Multistate Licensurefor EXISTING ACTIVE OKLAHOMA LICENSEESAPPLICATION FEE 150.00Per 59 O.S. § 4100.8, there is NO fee required to submit this application if: you are active duty military personnel or the spouse of an active duty military personnelwho has received orders or notice for military transfer or honorable discharge to thisstate; and you have a valid license in another state at the same level of licensure in good standingwith requirements reasonably equivalent to this state.Please see the “Military Personnel” section for more information.Use this application if you: Wish to apply for a multistate license; Are currently licensed as a Registered Nurse (RN) or Licensed Practical Nurse (LPN)in Oklahoma and your license is active and unencumbered (e.g., your license is notrevoked, suspended, on probation, monitored, on conditions, limited, or any otherencumbrance on licensure affecting your authorization to practice); and Declare Oklahoma as your primary state of residence (see the section titledDeclaration of Primary State of Residence in the application instructions for details).General InformationEffective January 19, 2018, Registered Nurses and Licensed Practical Nurses who hold anOklahoma license in active status and meet certain requirements are eligible to apply for multistatelicensure. Once the Board grants the multistate license, the nurse can then engage in nursingpractice in any of the Enhanced Nurse Licensure Compact states without having to obtainadditional licenses. A list of states participating in the Enhanced Nurse Licensure Compact isavailable at htm.Do not submit this application unless your Oklahoma license is active and unencumbered, and youdeclare Oklahoma as your primary state of residence; otherwise, Board staff will not proceed withreview of your application.Not all applicants will be eligible for a multistate license. In order to be eligible, the applicantmust submit an application, pay a fee, submit fingerprints for a federal criminal background check,Form RS-46111/01/2019

and meet the requirements listed in the following section. Because licensing laws change overtime, it is possible that requirements that are now in place were not in place at the time you obtainedyour Oklahoma license. In addition, records submitted at the time you were licensed may nolonger be available for review by Board staff. Therefore, to determine whether you meet therequirements for the multistate license, Board staff may request additional information. In somecases, this will involve additional time and fees as required by other entities; including but notlimited to time and fees to obtain an official transcript, to verify international education by anindependent credentials review agency, to complete English language testing for the nurse whowas educated in another country, or to obtain a verification of licensure information from anotherstate. Only submit an application if you meet all requirements listed as fees are nonrefundable.REQUIREMENTS for a MULTISTATE LICENSE for EXISTINGACTIVE OKLAHOMA LICENSEESAn Oklahoma-licensed RN or LPN with a single-state license in active status is eligible to applyfor a multistate license. In order to be eligible for a multistate license, the RN or LPN must meetthe following requirements:1.Meets Oklahoma's qualifications for licensure or renewal of licensure, as well as allother applicable state laws;2.Has graduated or is eligible to graduate from a licensing-board-approved RN orLPN/VN prelicensure education program;ORHas graduated from a foreign RN or LPN/VN pre-licensure education program that:a. has been approved by the authorized accrediting body in the applicable countryandb. has been verified by an independent credentials review agency to be comparableto a licensing-board-approved pre-licensure education program;3.Has successfully passed an English proficiency examination that includes thecomponents of reading, speaking, writing and listening; if a graduate of a foreign prelicensure education program not taught in English or if English is not the individual'snative language;4.Has successfully passed an NCLEX-RN or NCLEX-PN Examination or StateBoard Test Pool Examination, as applicable;5.Is eligible for or holds an active, unencumbered license;6.Has submitted, in connection with an application for initial licensure or licensure byendorsement, fingerprints or other biometric data for the purpose of obtaining criminalForm RS-46211/01/2019

history record information from the Federal Bureau of Investigation and the OklahomaState Bureau of Investigations;7.Has not been convicted or found guilty, or entered into an agreed disposition, of afelony offense under applicable state or federal criminal law;8.Has not been convicted or found guilty, or entered into an agreed disposition, of amisdemeanor offense related to the practice of nursing as determined on a case-bycase basis;9.Is not currently enrolled in an alternative program;10.Is subject to self-disclosure requirements regarding current participation in analternative program;11.Has a valid United States Social Security number; and12.Declares Oklahoma as the primary state of residence.When the Board office receives your application, the Board staff will review both your applicationand licensure records already on file to ensure that you meet all requirements for a multistatelicense. Please be aware that if the Board staff are not able to verify through your application andlicensure records that you meet all requirements, they may request additional information fromyou.Review of criminal charges, disciplinary action, judicial declaration of incompetence, orparticipation in an alternative program: Applicants who have ever been summoned, arrested,taken into custody, indicted, convicted or tried for, or charged with, or pleaded guilty to, theviolation of any law or ordinance or the commission of any misdemeanor or felony, or requestedto appear before any prosecuting attorney or investigative agency in any matter; or have ever haddisciplinary action taken against a nursing license, certification or registration, any professional oroccupational license, registration, or certification and/or any application for a nursing orprofessional or occupational license, registration, or certification or if there is currently anyinvestigation of your nursing license, registration, or certification; and/or any professional oroccupational license, registration, or certification; and/or any application for a nursing and/orprofessional or occupational license, registration, or certification in any state, territory or country;or have ever been judicially declared incompetent; or are currently participating in an alternativeto discipline program in any state, territory, or country are required to notify the Oklahoma Boardof Nursing. A “report in writing” means that the applicant/licensee provides a signed and dateddescription stating in his/her own words the date, location, and circumstances of the incident, andif applicable, the resulting action taken by the court, agency, or disciplinary board. The report maybe in the form of a letter or a statement in the provided space on the application. The report mustbe accompanied by certified court records or a board order. A verbal report does not constitute a“report in writing”. A written report not accompanied by a full set of certified court records or theForm RS-46311/01/2019

board order(s) does not constitute a “report in writing”. Failure to report such action is a violationof the Oklahoma Nursing Practice Act.Military Personnel:Per 59 O.S. § 4100.8, if you are an active duty military personnel or the spouse of an active dutymilitary personnel who has received orders or notice for military transfer or honorable dischargeto this state, please provide to the Board’s office a copy of the United States Uniformed ServicesIdentification and Privilege Card and a copy of the military member’s Permanent Change ofStation (PCS) orders. No application fee is required. Following confirmation that you hold a validlicense in another state that is in good standing and reasonably equivalent to the requirements ofthis state, a temporary license will be granted within 30 days.INSTRUCTIONS FOR COMPLETION OF THE APPLICATION1.Completion of application: Please complete and submit the application online on theBoard’s website: x.php. You mayrequest a paper copy by submitting a written request for such to the Board office. Youmust include a self-addressed, pre-postage-paid 8 ½ x 11 inch return envelope ( 1.06postage cost) for Board staff to return a paper copy of the application.If submitting a hard copy application, you may NOT use correction fluid on theapplication. When you are finished entering your information, sign the applicationLEGIBLY, using your full legal name.You must provide a Social Security number on the application. This information ismandatory, pursuant to 56 O.S. § 240.21A and 59 O.S §567.21.2.Fee: You may pay the application fee online, using a VISA, a MasterCard or an electronicfund transfer when completing the application. Fees submitted are not refundable. Ifyou submit a hard copy application, attach to your application the appropriate fee payableby cashier’s check, money order, or personal check. If you do not submit the fee with theapplication or if the fee is incorrect, the application will be immediately returned withoutreview. If you meet either military personnel options listed in the Military Personnelsection, a fee is not required.3.Background Check: Each applicant must provide fingerprint images to be used for thepurpose of permitting a state and national criminal history records search through the OSBIand FBI. The criminal history records search must be conducted through the Board’svendor, Idemia, no more than ninety (90) days prior to receipt of the application in theBoard office. The results of the search are provided directly to the Board office by theOSBI usually within one to two weeks. Please read the Privacy Act Statement andForm RS-46411/01/2019

Applicant Notification found in the Appendix to this set of instructions. Procedures forchanging, correcting or updating OSBI and / or FBI results are set forth in Title 28, C.F.R.,§16.34 and will be furnished as needed.Option 1: If you have an Oklahoma mailing address, you will need to go to anIdentoGo center sponsored by Idemia located within the state to providefingerprints electronically. These sites are available by appointment only. You mustvisit the following website to schedule an appointment: www.identogo.com, or youmust call (877) 219-0197 to make an appointment. Payment can be made duringyour appointment or online when scheduling. Please note that your fingerprintsmust be obtained electronically only at an IdentoGO center sponsored byIdemia.Option 2: If you have an out-of-state mailing address, Board staff will mail youspecific fingerprint cards that you must take to a local law enforcement agency toobtain the fingerprints. Please note that you must wait to receive the specificcoded fingerprint cards from the Board office prior to obtaining yourfingerprints. An addressed envelope will be provided as the fingerprint cardsmust be mailed by the law enforcement agency directly to an IdentoGO centersponsored by Idemia. You are responsible for the postage and the costs associatedwith obtaining your fingerprints; OR If you are in Oklahoma, you may follow theinstructions for Option 1 above. Please note that you cannot be issued a multistatelicense from the State of Oklahoma unless you declare Oklahoma as your primarystate of residence.4.Criminal Charges, Disciplinary Action, Judicial Declaration of Mental Incompetence,or Alternative Program: If you answer “yes” to any of the questions in the section onHistory of Criminal Charges, Disciplinary Action, Mental Incompetence, or AlternativeProgram in the application, you must submit a statement on the application form,describing the date, location and circumstances of each incident, and the resultingaction(s) taken by the court or disciplinary board. If you have more than one incidentyou are reporting, you must speak to every case/charge that has been filed.Question #1 in the section on History of Criminal Charges, Disciplinary Action, MentalIncompetence, or Alternative Program in the application addresses a history of beingsummoned, arrested, taken into custody, indicted, convicted or tried for, or charged with,or pleaded guilty to, the violation of any law or ordinance or the commission of anymisdemeanor or felony, or been requested to appear before any prosecuting attorney orinvestigative agency in any matter. If you answer “yes” to question #1 in this section, youmust submit certified copies of the: Information Sheet, Incident Report, Complaint, and/or Charges (brief summary ofthe incident prepared by the court) Affidavit of Probable Cause (listing of the charges brought against you) Judgment and/or Sentence (findings of the court and sentence imposed) Verification that Judgment and/or Sentence requirements are complete.Form RS-46511/01/2019

Certified copies are copies of court records obtained from the courthouse in the county/citywhere the action occurred, dated and signed by the court clerk, and affixed with the courtseal. You may obtain these documents from the courthouse in the county/city or in thefederal court of the district in which the court action occurred. The Board staff will notaccept Internet court documents, such as Oklahoma Court Information System casereports. Please note that you must report all arrests and/or charges that have beenbrought against youIf no records are found, have the agency provide a certified letter stating no records werefound in a search from the date of offense through current.Question #2 in the section on History of Criminal Charges, Disciplinary Action, MentalIncompetence, or Alternative Program in the application addresses a history of disciplinaryaction taken against a nursing license, certification or registration; any professional oroccupational license, registration, or certification; and/or any application for a nursing orprofessional or occupational license, registration, or certification. If you answer “yes” toquestion #2 in this section, please request that a certified copy of the Board order besubmitted directly to the Board office from the licensing agency.Question #4 in the section on History of Criminal Charges, Disciplinary Action, MentalIncompetence, or Alternative Program in the application addresses a history of having beenjudicially declared mentally incompetent. If you answer “yes” to question #4 in thissection, please submit a certified copy of the Court Order(s).Question #5 in the section on History of Criminal Charges, Disciplinary Action, MentalIncompetence, or Alternative Program in the application addresses current participation inan alternative to discipline program. If you answer “yes” to question #5 in this section,please request that a certified copy of the Board Order and/or alternative programparticipation documents be submitted directly to the Board office from the licensing agencyand/or alternative program.5.Declaration of primary state of residence: In order to be eligible to obtain a multistatelicense from the State of Oklahoma, you must declare Oklahoma as your primary state ofresidence. If you do not have a current Oklahoma mailing address, you must provide alegible, color copy of one of the following documents:a.b.c.d.e.Driver’s license with a home address;Voter registration card displaying a home address;Federal income tax return declaring the primary state of residence;Military Form No. 2058 (state of legal residence certificate); and/orW2 from US Government or any bureau, division or agency thereof indicating thestate of residence.If you do not have one of these documents, please contact the Board office for furtherdirection regarding the processing of your application.Form RS-46611/01/2019

OTHER INFORMATIONYou are required to notify the Board in writing of any address changes occurring during theapplication process. This notification must be signed and submitted in person, by mail, or byfacsimile.Your application to the Board is valid for six (6) months after receipt. After that time, a newapplication and fee must be submitted. Applications are processed in the order they are received.Applications are processed in the order they are received. Repeated telephone calls to check on thestatus of your application will delay, rather than facilitate, the processing of your application. Feessubmitted are not pro-rated and are not refundable.In accordance with Oklahoma law (59 O.S. §567.7 (E)), the Executive Director shall suspend thelicense or certificate of a person who submits a check, money draft, or similar instrument forpayment of a fee which is not honored by the financial institution named. The suspension becomeseffective ten (10) days following delivery by certified mail of written notice of the dishonor andthe impending suspension to the person’s address on file. Upon notification of suspension, theperson may reinstate the authorization to practice upon payment of the fees and any and all costsassociated with notice and collection. The suspension shall be exempt from the AdministrativeProcedures Act.COMMON MISTAKES THATDELAY APPLICATION PROCESSING Leaving application questions incomplete or unanswered, or using correction fluid onthe hard-copy application Failing to provide the full name under which you were licensed (with the notation“NMN” if there is no middle name) Failing to provide a complete description and documentation regarding history ofcriminal charges, disciplinary action, judicial declaration of incompetence, oralternative program Failing to provide fingerprint images to an IdentoGo Center to be used for a state andnational criminal history records search through the OSBI and FBIForm RS-46711/01/2019

AppendixPrivacy Act Statement and Applicant NotificationAuthority: The FBI’s acquisition, preservation, and exchange of fingerprints and associatedinformation is generally authorized under 28 U.S.C. 534. Depending on the nature of yourapplication, supplemental authorities include Federal statutes, State statutes pursuant toPublic Law 92-544, Presidential Executive Orders, and federal regulations. Providing yourfingerprints and associated information is voluntary; however, failure to do so may affectcompletion or approval of your application.Principal Purpose: Certain determinations, such as employment, licensing, and securityclearances, may be predicated on fingerprint-based background checks. Your fingerprintsand associated information/biometrics may be provided to the employing, investigating, orotherwise responsible agency, and/or the FBI for the purpose of comparing your fingerprintsto other fingerprints in the FBI’s Next Generation Identification (NGI) system or itssuccessor systems (including civil, criminal, and latent fingerprint repositories) or otheravailable records of the employing, investigating, or other responsible agency. The FBI mayretain your fingerprints and associated information/biometrics in NGI after the completion ofthis application and, while retained, your fingerprints may continue to be compared againstother fingerprints submitted to or retained by NGI.Routine Uses: During the processing of this application and for as long thereafter as yourfingerprints and associated information/biometrics are retained in NGI, your information maybe disclosed pursuant to your consent, and may be disclosed without your consent aspermitted by the Privacy Act of 1974 and all applicable Routine Uses as may be publishedat any time in the Federal Register, including the Routine Uses for the NGI system and theFBI’s Blanket Routine Uses. Routine uses include, but are not limited to, disclosures to:employing, governmental or authorized non-governmental agencies responsible foremployment, contracting, licensing, security clearances, and other suitabilitydeterminations; local, state, tribal, or federal law enforcement agencies; criminal justiceagencies; and agencies responsible for national security or public safety.Applicant Record ChallengeApplicant Record Challenge: Before a final decision is made, you have the opportunity tocomplete or challenge the accuracy of the information contained in the FBI identificationrecord. The procedure for obtaining a change, correction, or updating an FBI identificationrecord is set forth in Title 28, CFR 16.34. For information on updating the national criminalhistory record, visit www.FBI.gov or hecks#challenge-of-an-identity-history-summary.If certified documents are obtained for the purpose of updating your criminal history record,the documents should be forwarded to the FBI and to the repository in the state where thearrest occurred.Form RS-46811/01/2019

Oklahoma Board of Nursing 2501 N. Lincoln Blvd., Suite 207 . Oklahoma City, OK 73105 (405) 962-1800 www.nursing.ok.gov . Instructions for Applying for Multistate Licensure for . EXISTING ACTIVE OKLAHOMA LICENSEES . APPLICATION FEE 150.00 Per 59 O.S. § . state; and you have a valid license in another state at the same level of licensure in .

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