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University of Pittsburgh School of Nursing Initial Health Form DATA AND IMMUNIZATION RECORD THE INFORMATION CAN BE ENTERED BY THE FACULTY. ALL INFORMATION MUST BE IN ENGLISH. COPIES OF ORIGINAL RECORDS
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01
Obtain a blank certificate form from the relevant authority or institution.
02
Fill in your full name as it appears on your identification document.
03
Enter your date of birth in the specified format (e.g., MM/DD/YYYY).
04
Provide your address, including city, state, and zip code.
05
Indicate the date you completed your licensed practical nursing program.
06
List the name of the institution where you completed your education.
07
Include any required identification numbers, such as a social security number or candidate number.
08
Sign and date the certificate, certifying that the information provided is accurate.
09
Submit the completed certificate form along with any required documentation or fees to the appropriate licensing board.

Who needs certificate in licensed practical?

01
Individuals who have completed a licensed practical nursing program.
02
Candidates seeking licensure to practice as a licensed practical nurse (LPN).
03
Healthcare employers requiring proof of qualification for nursing positions.
04
Students applying for further nursing education or programs.
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A certificate in licensed practical refers to a formal document that signifies an individual's qualification and authorization to practice as a licensed practical nurse (LPN) after completing necessary training and passing required examinations.
Individuals who have completed their education and training as licensed practical nurses and are seeking licensure to practice are required to file the certificate.
To fill out the certificate, applicants usually need to provide personal information, educational background, details of their nursing program, and pass certain exams. Specific forms can be obtained from the nursing board or authority in their state.
The purpose of the certificate in licensed practical is to ensure that individuals are qualified to provide safe and effective nursing care, verify their training, and authorizing them to practice as licensed practical nurses.
Information that must be reported typically includes the applicant’s full name, date of birth, nursing school attended, graduation date, examination scores, and any relevant licenses or certifications.
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