Forms and Applications

We want to to provide easy access to the forms and applications you need. On this page, you can find information and sample application forms for nurses, medication aides, dialysis technicians, community health workers and more.
All licensure and certification applications must be completed online. Please go to the home page and click the button “Licensing-Apply/Renew Online" to access the online applications. The “sample” applications on this website are for reference only and are provided for informational purposes.

Criminal Records Checks

Go to the Licensing, Certification & CE section located at the top of the website and on that page, see the information for Criminal Records Checks.

Check the Status of Your License Application

To check the status of a license application, log onto your dashboard, click “options” and then “review status.” If you need assistance accessing your Dashboard, please contact the Ohio eLicense Customer Service Help Desk at 614-466-3947 Option 1 Monday-Friday, 8am-5pm.

 

Application Fees Must be Paid Online Using a Credit or Debit Card

Application fees must be paid online using a Master Card, VISA or Discover credit or debit card. If you do not have this type of personal credit or debit card, you can obtain these pre-paid cards at local stores.

If the fee is not paid when you submit your application online, the application will be incomplete and will not be processed until you submit all required fees. All fees are non-refundable.

If you purchase a prepaid Master Card, VISA or Discover credit or debit card, please have enough funds on it to cover (a) the credit/debit card company’s processing fee, if applicable; (b) the Board’s application fee; and (c) the state’s transaction fee of $3.50.

RN and LPN Licensure by Examination Application

Please go to the front page of the website and click the button “Licensing-Apply/Renew Online” to access the online applications. The sample applications are for reference only and provided for informational purposes.

RN and LPN Licensure by Endorsement (Reciprocity) Application

For information about verification of your out-of-state license, go to the Licensing, Certification & CE section at the top of the website, click on “RN, LPN, and APRN,” and scroll to Out-of-State Nurse Applicants.” To apply, go to the home page and click the button “Licensing-Apply/Renew Online” to access the online applications. The sample applications are for reference only and provided for informational purposes.

LPN IV Therapy Form

LPNs who are licensed in Ohio to administer medications and want to become licensed to provide IV therapy must complete an approved Intravenous Therapy CE Course.

Advanced Practice Registered Nurse Applications: Initial Licensure; Renewal; Reinstatement/Reactivation

RN and LPN License Renewal, Reinstatement/Reactivation Applications

Nursing Education Program Related Forms

Program Completion Letter Guidelines

The Board of Nursing accepts completion program letters by email. Find guidance documents and samples below. If you have any questions, please email education@nursing.ohio.gov.

New Program Proposal Forms

Education Program Pre-Survey Visit Forms

Education Program Annual Report Form

Continuing Education Related Forms

Nursing Education Grant Program (NEGP Forms)

Community Health Worker Certification Applications and Training Program Application Forms

Please go to the front page of the website and click the button “Licensing-Apply/Renew Online” to access the online applications. The sample applications are for reference only and provided for informational purposes.

Program Approval Forms

Dialysis Technician Certification Applications and Training Program Application Forms

Medication Aide Certification Applications and Training Program Application Forms

Please go to the front page of the website and click the button “Licensing-Apply/Renew Online” to access the online applications. The sample applications are for reference only and provided for informational purposes.

Program Approval Forms

Volunteer Certificate Forms

Alternative Program for Substance Use Disorder

Compliance Post-Disciplinary Monitoring

Medical Clearance to Return to Play after Suspected Concussion Form

Verification Form for Organizations Issuing National Certification for Advanced Practice Registered Nurses

Request for Replacement Wall Certificate Form