Recertification Paper Applications and Documents

1. Certificants must create or update their Online Profile.
2. Certification renewal may be done with an Online or Paper application. Documents may be uploaded to the Online application.
3. Steps to complete the Paper application form:

• Download the appropriate Renewal of Certification application form.
• Paper applications are fillable PDF forms. Type directly into the application form, then save to your computer. The latest version of Adobe Reader is required. Download Adobe Reader (Free)
• Return the completed application form via email or mail.
• For additional information, refer to FAQs and the Recertification Handbook [2MB .pdf]

Renewal of Certification by Practice Hours and CE Application [591KB .pdf]

Renewal of Certification by Examination Application [472KB .pdf]

AGNP, ENP, FNP, and PMHNP Certification Examination Retake Application [293KB .pdf]

Preceptorship Form [230KB .pdf]

Continuing Education Log [192KB .pdf]

Other Related Documents

Adult-Gerontology Primary Care Nurse Practitioner Conversion Application [200KB .pdf]