Forms and Publications

Forms

Consumers

Document Title
Consumer Complaint Form

Applicants

Document Title
Applicant Live Scan Fingerprint Form
Application for Psychiatric Technician Licensure by Examination
Application for Vocational Nurse Licensure by Endorsement
Application for Vocational Nurse Licensure by Examination
Authorization for Release of Confidential Information - (55P-6)
Authorization for Release of Confidential Medical Records and Information - (55P-5)
Interim Permit VN
Interim Permit PT
PT Employment Verification

Education

Document Title
Annual Report Form 2015
Approved Vocational Nursing Schools
Approved Psychiatric Technician Schools
Clinical Facility Approval Application
Faculty Approval Application
New Program Application
Psychiatric Technician Blood Withdrawal Certification Course Providers
Psychiatric Technician Continuing Education Course Providers
Vocational Nurse Blood Withdrawal Certification Course Providers
Vocational Nurse Continuing Education Course Providers
Vocational Nurse IV Therapy Certification Course Providers
Vocational Nurse IV Therapy/Blood Withdrawal Certification Course Providers
Unaccredited Nursing Programs

Licensees

Document Title
Address Change Request Form - (55P-4)
Application for Renewal
Application for Replacement PT License - (55CP-4)
Application for Replacement LVN License - (55C-4)
Employer Mandatory Reporting Form
Employment Verification - Nursing Experience - (55A-12)
Expert Witness Application
Fee Schedule
License Live Scan Fingerprint Form
Licensee Mandatory Reporting Form
Name Change Request Form - (55P-3)
Notice on Collection of Personal Information For Applicants and Licensees

Enforcement

Document Title
How To File A Complaint

Publications

Document Title
BVNPT 2016 Biennial Sunset Review Report
Executive Summary Second Report
2014 Sunset Report
Approved School Lists
Board Member Administrative Procedure Manual
Disciplinary Action Lists
Employer Mandatory Reporting
Fact Sheet (Out-of-State Applicants)
Initiating A Board Approved Program
Licensed Vocational Nurse Fact Sheet
Licensee Mandatory Reporting
Mandatory Reporting Requirements for Child Abuse or Neglect, Elder Abuse and Dependant Adult Abuse, Performance Requirement and Conscientious Infection Control
Strategic Plan 2015

Brochures:

Document Title
Consumer Protection and the Enforcement Program
Enforcement Division
Protecting California’s Healthcare Consumers