• NH has a mandatory licensing law. No person may practice as a nurse or nursing assistant without a license. The NH Board of Nursing defines "practicing" as including attendance at orientation or completing other types of non-director care activities. (Exception: Applicants, other than secondary students, who have completed a board-approved nursing assistant education program may work without being licensed for 120 days from the program's last day of class.)

• Criminal record authorization forms are available on line. You must contact the Board office for the FBI fingerprint cards. For more information or any questions, please see the Board's home page.

• All completed, signed forms are legal documents and must be reproduced as they appear. Incomplete or poorly printed forms will be returned.

• Most license applications may be completed using the on-line licensing system as opposed to the "paper forms" below. Go to the on-line licensing link. FBI fingerprint and the criminal record release authorization forms must be filed with the NH Division of State Police, and received and reviewed by the NH Board of Nursing before a license can be issued. See paragraph above for obtaining these forms and fingerprint cards.

MOST COMMONLY USED FORMS

Registered Nurse Licensure Applications

• Application for License by Exam
• Application for License by Endorsement
• Instructions for Completing License Verification Process

Registered Nurse: Canadian Educated Licensure Applications

• Application for Canadian Educated Nurse: Endorsement of Canadian License

Practical Nurse Licensure Applications

• Application for License by Exam
• Application for License by Endorsement
• Instructions for Completing License Verification Process

Advanced Registered Nurse Practitioner Licensure Applications

• Application for Initial Licensure
• Application Temporary Licensure: New Graduated Only

Licensed Nurse Assistant Licensure Applications

• Initial LNA license application by competency evaluation and comparable education
• Application for License by Endorsement
• Medication Nursing Assistant Certification Application

• Clinical Practice Inquiry Form
• Change of Name/Address
• Complaint Form
• Criminal Background Check
• Educational Complaint Reporting Form
• Audit form
• Interim Education Report Form
• Road to Recovery to Release Information
• Joint Health Council Drug Request Form

• Educator Faculty Approval Form
• Faculty Prerequisites
• Annual program review form

• LNA Education Program Request for On-Site Visit
• LNA Education Program Self Evaluation Report
• MNA Education Program Request for Approval and On-Site Visit
• Challenge Program Self-Assessment
• Train the Trainer Program Self-Assessment

1. Please use quality paper for printing the application (white 8 1/2 x 11 inch paper must be used).
   
2. Be sure that the form prints completely, making sure that all text is legible, and all boxed content, seals and symbols are displayed.
   
3. Read and follow the application form directions.
   
4. Respond to all questions and fill in all requested information.
   Note: If the answer is none or N/A, please state so. Applications not completely filled out will be returned to you as incomplete.
   
5. Submit the completed application form to the New Hampshire Board of Nursing
   Be sure to sign and date the form and include the correct application fee
   

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  • February 2008 Newsletter

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 All the forms above are in Microsoft Word format, unless indicated otherwise. You can download a free reader from Microsoft.