03/19/2018

PHONE (717)783-7142 FAX (717) 783-0822

PENNSYLVANIA STATE BOARD OF NURSING P.O. BOX 2649 HARRISBURG, PA 17105-2649 www.dos.pa.gov/nurse

Email: st-nurse@pa.gov

Online Instructions for Registered Nurse or Practical Nurse Licensure by Endorsement &/or TPP

Read this Entire Document Prior to Any Application Submission & Print/Retain for Reference.

All fees are non-refundable and must be paid by credit or debit cards. A social security number (SSN) is required for an ONLINE application submission. Applicants without a SSN should upload a Waiver Form

The practice of nursing in Pennsylvania (PA) without a current valid PA Temporary Practice Permit (TPP) or license is illegal and prosecutable.

All applicants must upload a recent Criminal History Records Check (CHRC) from the state police or other state agency for every state in which you have lived or worked for the past five (5) years. The report(s) must be dated within 90 days of the date the application is submitted. For applicants living or working in Pennsylvania, request your CHRC from the Pennsylvania State Police at https://epatch.state.pa.us. For applicants living or working in California and/or Arizona: Due to the laws of these states, the Board is not an eligible recipient of CHRC's from California and Arizona. In lieu of obtaining a CHRC from California or Arizona, please obtain your Federal Bureau of Investigation (FBI) Identity History Summary Check, available at https://www.fbi.gov/services/cjis/identity-history-summary-checks.For individuals living and working in multiple (three or more) states during the past five (5) years, In lieu of obtaining individual state criminal background checks, you may elect to provide BOTH a state CHRC from the state in which you currently reside, AND your FBI Identity History Summary Check, available at the link noted above.

APPLYING FOR A LICENSE BY ENDORSEMENT: $100.00

Step 1: Click on the link Login at https://www.pals.pa.govStep 2: Login with your "User ID" and "Password". If you do not have one, or have forgotten your information, follow the options on the menu to the right side of the page.Step 3: Once you are logged into your PALS dashboard. Click on Apply for New License, located at the bottom of the page. The screens that follow will be a series of questions to assist with obtaining the correct application.

Board/Commission - Select State Board of Nursing

License Type - Select Registered Nurse or Practical Nurse

Survey - Please answer all questions on the survey to obtain the correct application and instructions.

PLEASE NOTE: You can apply for a Temporary Practice Permit by answering a question within the Endorsement application. A fee of $35.00 will be added to your account prior to payment. DO NOT SUBMIT A SEPARATE APPLICATION.

EVALUATION TIME FRAMES: The current evaluation time for the initial review of an Endorsement application is approximately 10 weeks from the date the application is received. You can check the status of your application and any correspondence by signing in to your PALS Dashboard.

The current evaluation time for the review of a Temporary Permit application is approximately 3 weeks from the date the application is received. You can check the status of your application and any correspondence by signing in to your PALS Dashboard.

http://www.dos.pa.gov/nursemailto:st-nurse@pa.govhttps://www.pals.pa.gov/https://www.pals.pa.govhttp://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Documents/Applications%20and%20Forms/SSN%20Waiver%20Form.pdfhttps://epatch.state.pa.us/https://www.fbi.gov/services/cjis/identity-history-summary-checks/

03/19/2018

ADDRESS OR NAME CHANGES: Applicants legal name must be entered on the application. Licensees are responsible to advise the Board of any address or name change within 14 days of the change. Licenses/permits are not forwarded. Complete a Change of Name and/or Address located on your PALS Dashboard,

whenever there is a change of name and/or address.

TEMPORARY PRACTICE PERMIT (TPP) INFORMATION:

If you hold an active license in the U.S., U.S. Territory or Canada you may apply for a TPP. The practice of nursing may begin after a TPP is issued by the Board. A TPP can be verified at www.pals.pa.gov/verify The TPP will expire one-year from the date of issue or if the permanent PA license is issued. Applicants previously issued a TPP in one licensure classification (RN, PN) are not eligible for a second TPP in the same

classification. A TPP may be extended for up to 1 year under certain circumstances, by submitting the application found at www.dos.pa.gov/nurse

REQUIREMENT FOR ACT 31 OF 2014 TRAINING: The Bureau of Professional and Occupational Affairs (BPOA), in conjunction with the Department of Human Services (DHS), is providing notice to all health-related licensees and funeral directors that are considered mandatory reporters under section 6311 of the Child Protective Services Law (CPSL) (23 P.S. 6311), as amended, that EFFECTIVE JANUARY 1, 2015, all persons applying for issuance of an initial license shall be required to complete 3 hours of DHS-approved training in child abuse recognition and reporting requirements as a condition of licensure. Please review the Board website www.dos.pa.gov/nurse under the link: General Board Information for further information on approved CE providers. Once you have completed a course, the approved provider will electronically submit your name, date of attendance, etc., to the Board.

ENGLISH PROFICIENCY REQUIREMENT: If your nursing education program was not conducted in English, you must provide the Board with evidence of English proficiency by achieving a passing score on a Board-approved exam. A list of Board Approved English Proficiency Examinations are on our Board website www.dos.pa.gov/nurse under the link: General Board Information. English Proficiency Test scores must be submitted directly to the Board from the testing agency.

LEGAL QUESTIONS: If YES is checked for any legal question, upload:

A detailed, signed and dated personal statement explaining the action, its background and any rehabilitation. Copies of criminal Court documents. Certified copies of all disciplinary actions from the Boards that imposed action.

http://www.dos.pa.gov/nursehttp://www.dos.pa.gov/nursehttp://www.dos.pa.gov/nursehttps://www.pals.pa.gov/verifyhttp://www.dos.pa.gov/nursehttp://www.ncsbn.orghttp://www.dos.pa.gov/nurse

STEPS TO APPLY ONLINE for a License and/or TPP (Permit): A SEPARATE online application and fee are required for licensure and/or Graduate Temporary Practice Permit (TPP), you can use the same user ID and Password to submit another application. This means if you are applying for licensure AND a Temporary P...APPLYING FOR A LICENSE by EXAMINATION: PA Program Graduate - $35.00 Out of State Program Graduate - $100.00Exam (PA Program New Graduate) orAPPLYING FOR A TEMPORARY PERMIT: PA Program Graduate - $35.00 Out of State Program Graduate - $35.00PA Program New Graduate orREQUIREMENT FOR COMPLETING THE LICENSURE EXAM WITHIN 1 YEAR:REQUIREMENT FOR ACT 31 OF 2014 TRAINING:

ADDRESS OR NAME CHANGES:SOCIAL SECURITY NUMBERNEW GRADUATE TEMPORARY PRACTICE PERMIT (TPP) INFORMATION:OUT-OF STATE PROGRAM GRADUATES APPLYING FOR LICENSURE BY EXAM AND/OR TPP: In addition to applying as directed above, graduates of a nursing education program outside the state of Pennsylvania must submit the following:EXAM RESULTS:REEXAM APPLICANT INSTRUCTIONS (Instate or Out-of State Applicants):PENNSYLVANIA STATE BOARD OF NURSINGNote: If the Graduate is applying for both Graduate TPP and Exam, only 1 Nursing Education Verification Form is required.Date student completed the nursing education program: - _- Award:

X(Name stamp or electronic signature is not acceptable.)Date:(Valid for one (1) year)