link to wv.gov state portal State Agency Directory |  Online Services
wvrnboard homelink
West Virginia

RN Board

nursing banner

Forms

Online Services:

RN Reinstatement Application

Advanced Practice Initial, Reinstatement and Renewal applications 

Prescriptive Authority Initial, Reinstatement and Renewal applications

NOTE - those with prescriptive authority need to renew both their Advanced Practice license and Prescriptive Authority privilege by June 30, 2017. Failure to renew your APRN license will cause your prescriptive authority privilege to lapse. 


Printed forms:


RN applications

Endorsement Application (resulting in both temporary and permanent licensure)

 - OR - 

Endorsement Application (resulting in temporary 90-day license ONLY, non-renewable, no permanent license)

Exam Application Packet (must also complete Pearson Vue application) 

Volunteer License  (law related to Volunteer License)


Prescriptive Authority forms

Collaborative Agreement Form

Dissolvement of Collaborative Agreement


Dialysis Tech Forms

Dialysis Tech Initial and Endorsement Application

Dialysis Tech Reinstatement Form


Other Forms

Lost or Duplicate License

WV Verification Form

NURSYS Verification

Complaint Form

 

Fee Schedule:

 

Address Change No Charge
Duplicate License $10.00
Endorsement without Temporary Permit $100.00 (Money Order or Cashier's Check)
Endorsement with Temporary Permit $125.00 (Money Order or Cashier's Check)
Endorsement with 90-day Temporary Permit ONLY $25.00 (Money Order or Cashier's Check)
Licensure by Examination $70.00 (Money Order or Cashier's Check)
RN Renewal $65.00
Advanced Practice Application $35.00
Advanced Practice Renewal $35.00
Limited Prescriptive Authority $125.00
Name Change $10.00
Name Change with License Replacement $10.00
Reinstatement from Lapsed Status $115.00
Reinstatement from Inactive Status $25.00
Transcript Photocopy $5.00
Verification to Another Nursing Board
or Certification Body
$30.00 (Money Order or Cashier's Check)
Volunteer License No Charge
Working Without a Valid License Disciplinary fees

 

Contact Us | Site Map

Privacy, Security and Accessibility | WV.gov | USA.gov | © 2017 State of West Virginia