Nursing License Renewal Requirements Checklist
Review and confirm all necessary requirements for your nursing license renewal.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
State of Licensure
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Other
Nursing License Number
*
Current License Status
*
Active
Inactive
Expired
Pending Renewal
Have you completed all required Continuing Education (CE) credits for this renewal period?
*
Yes, all required CE credits completed
Some credits completed, more needed
No, not started
Employment Verification (check all that apply)
Currently employed as a nurse
Not currently employed as a nurse
Employment verification letter available
Other
Professional Conduct Attestation
*
I attest that I have not had any disciplinary actions since my last renewal
I have had disciplinary actions (please explain below)
If you selected disciplinary actions above, please provide a brief explanation.
Renewal Fee Payment Status
*
Paid
Not yet paid
Fee waiver requested
Checklist: Please confirm which of the following renewal requirements you have completed.
*
Completed application form
Submitted Continuing Education documentation
Provided employment verification
Paid renewal fee
Attested to professional conduct
Other
How confident are you that you have met all renewal requirements?
*
Not confident
1
2
3
4
Completely confident
5
1 is Not confident, 5 is Completely confident
Renewal Requirements Completion Table
*
Rows
Not Started
In Progress
Completed
Continuing Education
1
2
3
Employment Verification
4
5
6
Professional Conduct Attestation
7
8
9
Renewal Fee Payment
10
11
12
Additional comments or questions about your renewal process
Submit Checklist
Should be Empty: