Applicants with Health History
If a “yes” response is provided to any of the health history questions on the application, the applicant is required to submit supporting documentation including the relevant dates and circumstances and the names and addresses of the medical practitioners or hospitals who performed related treatments. The application is considered incomplete until all supporting documentation is provided to the department.
Applicants with License Discipline History
Applicants with prior disciplinary actions on any license from any state are required to submit the following supplemental documentation:
Board Actions – Certified copies of documents relative to any disciplinary action taken against any license. The documents must be certified and submitted by the agency or board that finalized the disciplinary action.
Self-Explanation – Applicants who have listed license discipline on the application must submit a letter to the board personally describing the circumstances that led to the disciplinary action. The letter should also include a thorough description of the rehabilitation taken by the applicant since the time of the event which would facilitate prevention of future occurrences.
Applicants with Criminal History
Applicants who have been convicted of a misdemeanor or felony; or entered a plea of guilty, nolo contendere, or no contest to any crime in any jurisdiction; even if adjudication was withheld by the court; must answer the criminal history questions on the application and provide the following supplemental documentation:
Final Dispositions/Arrest Records – Final disposition records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. If the records are not available, a letter on court letterhead must be sent from the clerk of the court attesting to records unavailability.
Completion of Sanctions – Probation and financial sanction records for offenses can be obtained at the clerk of the court in the arresting jurisdiction. Parole records for offenses can be obtained from the Department of Corrections or at the clerk of the court in the arresting jurisdiction. If the records are not available, a letter on court letterhead must be sent from the clerk of the court attesting to records unavailability.
Self-Explanation – Applicants who have listed offenses on the application must submit a letter personally describing the circumstances of the offense. The letter must include the date of the original offense, the charge, and the jurisdiction where the incident occurred.