Nursing License Renewal CEU Requirements Checklist

Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

State of Nursing License

Nursing License Number

Employer Name (if applicable)

List your completed CEU courses for this renewal period. Please include course title, provider, date completed, and number of contact hours for each.

Which of the following required CEU topics have you completed during this renewal period? (Select all that apply)

Total number of CEU contact hours completed for this renewal period

Have you met all state-specific CEU requirements for license renewal?

Please provide any additional comments or information relevant to your CEU requirements or license renewal (optional)