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9960 Mayland Drive, Suite 300 Henrico, Virginia 23233 www.dhp.virginia.gov/nha(804) 3674595 (Tel) (804) 9395973 (Fax) Email: ltc@dhp.virginia.govCHECKLIST AND INSTRUCTIONS FORPRECEPTOR REINSTATEMENT
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How to fill out preceptor reinstatement application template

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How to fill out preceptor reinstatement application

01
To fill out a preceptor reinstatement application, follow these steps:
02
Download the preceptor reinstatement application form from the official website.
03
Read the instructions provided with the form carefully to understand the requirements.
04
Fill in your personal details, such as name, contact information, and license number.
05
Provide the reason for your previous preceptor suspension and any supporting documentation.
06
Explain any remedial actions taken since the suspension and provide proof of completion.
07
Attach any additional documents required, such as certificates or letters of recommendation.
08
Double-check the application for completeness and accuracy.
09
Submit the filled-out application along with the necessary fees to the designated authority.
10
Wait for a response from the authority regarding the reinstatement decision.
11
Follow any additional steps or requirements provided by the authority to complete the reinstatement process.

Who needs preceptor reinstatement application?

01
Anyone who has had their preceptorship temporarily suspended and wishes to resume their role as a preceptor needs to fill out a preceptor reinstatement application.

What is PRECEPTOR REINSTATEMENT APPLICATION Form?

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PRECEPTOR REINSTATEMENT APPLICATION template instructions

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The preceptor reinstatement application is a formal request submitted by individuals who have previously held a preceptor status and wish to regain that status after having it revoked or expired.
Individuals who previously held a preceptor status and are seeking to reinstate it after a lapse or revocation are required to file the preceptor reinstatement application.
To fill out a preceptor reinstatement application, applicants should provide personal information, details of their previous preceptor status, and any relevant documentation supporting their request for reinstatement on the designated form.
The purpose of the preceptor reinstatement application is to evaluate and determine whether an individual is fit to return to their preceptor status, ensuring they meet any necessary qualifications and standards.
The information that must be reported includes personal identification details, previous preceptor experience, reasons for lapsing or revocation, and any continuing education or training completed since then.
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