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OutofState Practitioner Reporting Form Virginia Code 54.12408.4, enacted by Chapter 464 of the 2022 Acts of Assembly, permits health care practitioners licensed, certified, or registered in another
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How to fill out out-of-state temporary practitioner reporting

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How to fill out out-of-state temporary practitioner reporting

01
Obtain the out-of-state temporary practitioner reporting form from the appropriate licensing board or regulatory agency.
02
Read the instructions and guidelines carefully before filling out the form.
03
Provide your personal information such as name, contact details, and license number.
04
Specify the duration and purpose of your temporary practice out of state.
05
Include information about the state where you intend to practice temporarily.
06
Provide details about your current state license and any other relevant licenses or certifications.
07
Attach any supporting documents required by the form, such as a letter of approval from the host state.
08
Review the completed form for accuracy and completeness.
09
Submit the filled-out form along with any required fees to the licensing board or regulatory agency.
10
Keep a copy of the submitted form for your records.

Who needs out-of-state temporary practitioner reporting?

01
Any healthcare practitioner who holds a valid license in one state and intends to practice temporarily in another state needs to complete out-of-state temporary practitioner reporting. This may include physicians, nurse practitioners, physician assistants, physical therapists, and other licensed healthcare professionals.

What is Out-of-state temporary practitioner reporting -Virginia ... Form?

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Out-of-state temporary practitioner reporting is the process of reporting the temporary practice of healthcare professionals in a state where they are not licensed.
Healthcare professionals who are practicing temporarily in a state where they are not licensed are required to file out-of-state temporary practitioner reporting.
Out-of-state temporary practitioner reporting can typically be filled out online or through a designated form provided by the state's licensing board.
The purpose of out-of-state temporary practitioner reporting is to ensure that healthcare professionals are practicing legally and safely in states where they are not licensed.
Information such as the practitioner's name, license number, temporary practice location, duration of practice, and the reason for temporary practice must be reported on out-of-state temporary practitioner reporting.
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