Forms

Effective 11/1/07, New Requirements for Verification of Citizenship or Qualified Alien Status affect application submissions

• Additional Documentation Cover Sheet
• Advanced Practice Licensure
• Affidavit of Citizenship Status
  
• AUA Certification Application Instructions
• AUA Application for Rewrite Instructions
• Certificate for Framing
• Certificate of Incorporation
  
• Change of Address with Declaration of Primary State of Residence
  
• Closed School Transcript Request
• Electronic Prescribing
  • Compliance & Best Practice
  • FAQs
  • Request for Extension
• Employment Verification Form
• Endorsement - Single State License

  • Instructions for completion of the Endorsement Application for U.S. Educated Nurses
    
  • Instructions for completion of the Endorsement Application for Nurses Educated Outside the U.S.
  • NURSYS Website Link:
    http://www.nursys.com
    
• Evidence of Status
• Inactive Status Application
• Initial Determination of Eligibility for Licensure or Certification
• Information for Applicants with History of Arrest or Disciplinary Action
• Instruction and Form for Requesting Reasonable Accommodations for NCLEX
  
• Investigation/Discipline Forms

  • Nurse's Initial Medication Report
  • Nurse's Seventy-Two Hour Medication Report
  • Prescriber Medication Report
  • Report of Nursing Practice Incident
  • Report of Supervised Practice
  • Self Assessment Report
  • Support Group Attendance Form
    
• Multistate Licensure Instructions (Available 1/5/18)

  • Multistate Licensure by Endorsement for U.S. Educated Nurses
  • Multistate Licensure by Endorsement for Nurses Educated Outside the U.S.
    
  • Multistate Licensure by Examination
  • Multistate Licensure by Examination - Rewrite
  • Multistate Licensure for Existing Active Oklahoma Licensees
  • Multistate Licensure for Existing Not Active Oklahoma Licensees
    
• Name Change Request
• NCLEX - Single State License

  • Instructions for completion of the Licensure by Examination (RN and LPN) Application
  • Instructions for completion of the Rewrite Application
  • Instructions and Learning Packet for Practical Nurse Equivalency Candidates
  • Instructions for NCLEX or AUA Certification Candidates with History of Arrests/Convictions/Prior Disciplinary Actions
• Oklahoma Nursing Practice Act & Rules
• Peer Assistance Program Forms

  • Counselor Report Form
  • Nurse Support Group Facilitator Report Form
  • Sponsor Report Form
  • Supervised Practice Report Form
  • Support Group Attendance Form
• Prescriptive Authority (CNP, CNM, CNS)

  • Agreement for Physician Supervising Advanced Practice Prescriptive Authority
  • Change in Supervising Physician(s) for Advanced Practice Prescriptive Authority: Application and Instructions
  • Exclusionary Formulary
  • Prescriptive Authority CNP, CNM, CNS Instructions
  • Prescriptive Authority Continuing Education Tracking Form
    
  • Request for Review of Pharmacology Contact Hours)
• Prescriptive Authority (CRNA)

  • Inclusionary Formulary
  • CRNA Authority to Select, Order, Obtain and Administer Drugs Instructions
  • Prescriptive Authority Continuing Education Tracking Form
  • Request for Review of Pharmacology Contact Hours
• Reinstatement or Return to Active Status of License/ Certificate/Recognition - Single State

  • Advanced Practice Registered Nurse Licensure
  • AUA Certification
  • CRNA Authority to Select, Order, Obtain and Administer Drugs
  • Prescriptive Authority for CNP, CNM, CNS
  • RN/LPN Licensure
• Request for Nursing Students to Attend Board Meeting
• Request for Social Security Number Change/Correction
• Volunteer License Application and Instructions
• Written Verification of Licensure

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Oklahoma Board of Nursing
2915 N Classen, Ste. 524
OKC, OK   73106
TEL: 405.962.1800 FAX: 405.962.1821

For questions or comments regarding this webpage, please contact the
OBN Webmaster at: obnwebmaster@nursing.ok.gov

Every effort has been made to ensure that the information provided at this site is correct, but due to the changing nature of the Internet, the Board disclaims any responsibility for any inaccuracies.