N.H. Admin. Code § Ahp 601.01 - Application For Initial Licensure or Certification
(a) The
application form for initial licensure or certification shall be the
"Application for Initial Licensure or Certification" form approved by the
office of licensed allied health professionals board of directors on April 12,
2018.
(b) The application form
shall be provided by the board.
(c)
Applicants for full initial licensure and provisional licensure shall submit
the following to the board:
(1) A completed
"Application for Initial Licensure or Certification" form, revised 4/12/18, for
which the applicant shall:
a. Complete the
entire form using a keyboard or by printing the information legibly in ink;
and
b. Complete all sections of the
entire form or designate them as not applicable;
(2) A "2 x 2" photograph of the applicants
face taken within the immediately preceding 6 months; and
(3) A fee in accordance with
Ahp 301.02.
(d) The application form in (c)(1)
above shall have the applicant's notarized signature pursuant to Ahp
601.05.
Notes
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