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Board of Nursing Forms and Other Documents

Forms and Publications for the NH OPLC Board of Nursing

Board of Nursing Home

 

Important Information for all Licensees

  • New Hampshire has a mandatory licensing law. No person may practice as a nurse or nursing assistant without a license. The Board of Nursing defines "practicing" as including attendance at orientation or completing other types of non-director care activities.
  • All completed, signed forms are legal documents and must be reproduced as they appear.
  • Most license applications may be completed using the online licensing system as opposed to the "paper forms" below.

General Instructions for Forms

  • Please use quality paper for printing the applications (white 8 1/2 x 11 inch paper must be used).
  • Be sure that the form prints completely, making sure that all text is legible, and all boxed content, seals and symbols are displayed.
  • 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.
  • Be sure to sign and date the and include the correct application fee.

Advanced Practice Registered Nurse

Clinical Practice

Licensed Nursing Assistant Licensure Applications

Education Programs: Nursing Assistant and Medication Nursing Assistant

Education: Pre-Licensure RN, LPN, and Out of State Programs

LPN IV Program Review Documents

Other Forms

Registered Nurse / Licensed Practical Nurse Licensure Applications

  • There is not a process for on-line submissions of License by Examination (NCLEX) applications at this time.
  • The state criminal background check (Form DSSP 256 is available online) is the current form required for all nursing license by examination applicants during the State of Emergency. There is a $25 fee associated with the background check. Licensees receiving conditional licenses because of inability to obtain fingerprints/FBI background check will receive instructions regarding completion of the FBI criminal background check with fingerprinting after the conditional license is granted.
  • The Board office is unable to 'hold' applications or money/checks in the event an incorrect form or fee was submitted.
  • An applicant's signature on the single state criminal background check form (DSSP 256 Criminal History Record Information Release Authorization) may be notarized without being in the presence of the notary - please refer to the Governor's Emergency Order #11: Temporary authority to perform secure remote online notarization. The applicant will send the signed, notarized form to the Board of Nursing Office with the appropriate fee where we will process the payment and forward it on to the state police.
  1. License by Exam (Nur 303.02)
  2. License by Endorsement (Nurs 304.01)
  3. Foreign Educated Nurses (Nur 304.02 and Nur 304.03)
  4. Nursing License Reinstatement

Publications

Resources

What's New?

CLEAR Grant Project: Nursing

Board of Nursing Home