Management Branch Office of Licensing

Advanced Practice Nurse (APN) Online Application Instructions & Checklist Important Instructions about completing an online application. Qualifications – Colorado has a mandatory practice act, which means that you may not practice as an APN in this state without a Colorado or other compact state license. Submission of this application does not guarantee licensure; therefore, do not make life or career decisions based on the probability that you may receive a license. Plan ahead for the time it will take to receive and review all required documents and complete our evaluation. Requirements for licensure are outlined in the Colorado Revised Statutes, Board Rules and Policies. These documents are available online at: www.colorado.gov/dora/Nursing_Laws. If you have a pending or active Colorado Registered Nurse (RN) license, select the application for Certified Nurse Midwife, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist or Nurse Practitioner from the Nursing – Colorado RN Advanced Practice & Prescriptive Authority Applications drop-down list.  

If you hold a compact RN license in a compact state and wish to apply for a Compact-APN, proceed to the next page for instructions. If you wish to obtain a Colorado RN license, STOP NOW and visit the RN Applications and Forms webpage for information: www.colorado.gov/dora/Nursing_RN_Applications_Docs.

To obtain an APN as a Certified Nurse Midwife, Clinical Nurse Specialist, Certified Registered Nurse Anesthetist or Nurse Practitioner, you must: Hold an active or pending Colorado RN license. Pay the required fee: You must pay the application $75 processing fee with a credit card or electronic check to complete the application process. All fees are non-refundable and are subject to change. Provide verification of your National Certification (AANP, ANCCC, PNCB, AMCB, NCC, etc.): You must supply verification of your national certification at the time apply. Select your Population Focus (Clinical Nurse Specialist & Nurse Practitioner only): You must select at least ONE population focus. If you wish to be included in the registry in multiple populations, then you must supply verification of education OR active licensure and practice for each focus you wish to obtain. If you are applying on the basis of graduate or post-graduate education, you must: Provide Official Transcript(s) – You must ensure that your official transcript(s) with the conferred degree clearly printed on the transcript(s) be sent to the Office of Licensing - APN Registration. Your transcript(s) must demonstrate: • A graduate degree or higher as an APN in the role for which you are applying -OR• A graduate degree in Nursing and post-graduate degree or post-graduate certificate as an APN in the role for which you are applying. If you are applying on the basis of active licensure and practice, you must: List and Verify ALL APN Designations – You must list and verify ALL other APN designations you hold or have held in any other state or territory. You must also provide scanned verification of each designation at the time you apply. PLEASE NOTE: Your other APN designations must match the role and populations(s) for which you are applying for in Colorado.

1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800

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Confirm your Active Practice – You must attest that you have practiced for at least two years of the five years immediately preceding submission of your online application. PLEASE NOTE: Your active practice must match the role and populations for which you are applying for in Colorado. Maintain Professional Liability Insurance prior to Practice: You must carry or maintain upon commencement of independent practice in Colorado professional liability insurance in an amount of not less than $500,000 per claim with an aggregate liability limit for all claims during the year of $1,500,000 unless you are able to claim an exemption authorized in the Board’s Chapter XXI Rules. You may review the rules on the Laws, Rules and Policies webpage: www.colorado.gov/dora/Nursing_Laws. Provide your Primary State of Residence (PSOR): You must provide your PSOR, which is defined as the state of a person’s declared fixed permanent and principal home for legal purposes. You may be requested to provide documentation of your PSOR in the form of a driver’s license, voter registration, federal income tax return, military form no. 2058 or W2 from U.S. Government or any bureau, division or agency thereof. If you hold a compact-multi state license in a compact state, select the application for Compact Certified Nurse Midwife, Compact Clinical Nurse Specialist, Compact Clinical Registered Compact Nurse Anesthetist or Nurse Practitioner from the Nursing – Out of State RN Advanced Practice & Prescriptive Authority Applications dropdown list. To obtain a Compact-APN as a Compact Certified Nurse Midwife, Compact Clinical Nurse Specialist, Compact Certified Registered Nurse Anesthetist or Compact Nurse Practitioner, you must: Hold a compact RN license in a compact state. You may view a list of compact states on the National Council of State Boards of Nursing website: www.ncsbn.org/nurse-licensure-compact. Verify your Compact License – You must provide a scanned verification of your compact multi-state RN license at the time you apply. •

The verification can be from the other state or jurisdiction website, but must indicate whether disciplinary action has ever been taken against your license or if there are any pending complaints.

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If you are unable to access verification from the other state or jurisdiction website, you may request verification be sent directly to the Office of Licensing – APN Licensure at the address on the bottom of this page, but mailed verification will delay processing of your application.

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A copy of your license will NOT suffice.

Pay the required fee: You must pay the application $75 processing fee with a credit card or electronic check to complete the application process. All fees are non-refundable and are subject to change. Provide verification of your National Certification (AANP, ANCCC, PNCB, AMCB, NCC, etc.): You must supply verification of your national certification at the time apply. Select Population Focus (Compact Clinical Nurse Specialist & Compact Nurse Practitioner): You must select at least ONE population focus. If you wish to be included in the registry in multiple populations, then you must supply verification of education OR active licensure and practice for each focus you wish to obtain. If you are applying on the basis of graduate or post-graduate education, you must: Provide Official Transcript(s) – You must ensure that your official transcript(s) with the conferred degree clearly printed on the transcript(s) be sent to the Office of Licensing - APN Registration. Your transcript(s) must demonstrate: • A graduate degree or higher as an APN in the role for which you are applying -OR• A graduate degree in Nursing and post-graduate degree or post-graduate certificate as an APN in the role for which you are applying. If you are applying on the basis of active licensure and practice, you must: List and Verify ALL APN Designations – You must list and verify ALL other APN designations you hold or have held in any other state or territory. You must also provide scanned verification of each designation at

1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800

F 303.894.7693 www.dora.colorado.gov/professions

the time you apply. PLEASE NOTE: Your other APN designations must match the role and populations(s) for which you are applying for in Colorado. Confirm your Active Practice – You must attest that you have practiced for at least two years of the five years immediately preceding submission of your online application. PLEASE NOTE: Your active practice must match the role and populations for which you are applying for in Colorado. Provide your social security number: As of January 1, 2009, a Social Security Number is required for all licensees. Exceptions are made for foreign nationals not physically present in the United States and for nonimmigrants in the United States on student visas who do not have a Social Security Number. These applicants must submit a signed Social Security Number Affidavit in lieu of a Social Security Number. Provide name change documentation (if applicable): If you already have another type of license in Colorado and your name has since changed, you’re presenting documentation for licensure with a previous name, or if any required documentation has a different name on it, you’ll be required to upload proof of your name change. Complete the Affidavit of Eligibility: You will be asked to attest to and provide information that you are lawfully present in the United States or otherwise eligible to work here. Maintain Professional Liability Insurance prior to Practice: You must carry or maintain upon commencement of independent practice in Colorado professional liability insurance in an amount of not less than $500,000 per claim with an aggregate liability limit for all claims during the year of $1,500,000 unless you are able to claim an exemption authorized in the Board’s Chapter XXI Rules. You may review the rules on the Laws, Rules and Policies webpage: www.colorado.gov/dora/Nursing_Laws. Provide your Primary State of Residence (PSOR): You must provide your PSOR, which is defined as the state of a person’s declared fixed permanent and principal home for legal purposes. You may be requested to provide documentation of your PSOR in the form of a driver’s license, voter registration, federal income tax return, military form no. 2058 or W2 from U.S. Government or any bureau, division or agency thereof. Healthcare Professions Profiling Program (HPPP) – You’ll be asked a series of questions concerning your practice after submitting your online application. This profile is required for healthcare professionals in Colorado. Your application isn’t considered complete and a license cannot be issued until you have submitted your online profile. Your Healthcare Professions Profile is an ongoing responsibility; you must update your profile online within 30 days of changes and/or reportable events. As you complete your profile, please read the instructions carefully. For more information visit: www.colorado.gov/dora/HPPP or call 303-894-5942.

Information about the application process and how you will be contacted An Application Specialist will review your application based on the information you supply. If your application is incomplete, you will be contacted via the email address you provided. To monitor the status of your application, visit Online Services: apps.colorado.gov/dora/licensing/Default. Disclosure of addresses: Consistent with Colorado law, all addresses and phone numbers on record with the Division of Professions and Occupations (DPO) are public record and must be provided to the public when requested. It is your responsibility to keep your address and contact information current in our system. Your email address is not open to public record, but must be provided at the time you register an account. If your email address is not current, it is possible you will not receive important information from DPO. You can change your address, email address and other information online by using Online Services: apps.colorado.gov/dora/licensing/Default. Application expiration: Your application will be kept on file for one year from date of receipt in the Division of Professions and Occupations. Your file and all supporting documentation will be purged if you do not submit

1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800

F 303.894.7693 www.dora.colorado.gov/professions

required documents and complete your application process in one year. You will need to resubmit a new application packet and fee after that time. If you submitted an application within the last year and were notified that you did not meet the requirements and you are submitting an update, you do not need to complete a new application or submit additional fees. License Expiration Grace Period for New Applicants: PLEASE BE ADVISED that if you hold a compact multi-state th license, your APN will expire September 30 of either odd-numbered years or even-numbered years and is dependent on the issuance date. If you are issued a license within 120 days of the upcoming expiration date, you will be issued a license with the subsequent expiration date. For example, licenses issued between June 3, 2017 and September 30, 2017 will reflect an expiration date of September 30, 2019. Licenses issued prior to June 3, 2017 will reflect an expiration date of September 30, 2017 and must renew in the upcoming renewal period. 

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All APN licenses expire September 30 of odd-numbered years and must be renewed to continue practicing.

1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800

F 303.894.7693 www.dora.colorado.gov/professions

IMPORTANT NOTICE TO:

All Applicants

FROM:

Director of the Division of Professions and Occupations

SUBJECT:

Licensure and Criminal History

Thank you for your interest in becoming a licensed* professional within the Division of Professions and Occupations. Before you submit your application, please be aware of a few facts regarding criminal conduct, convictions, and disciplinary actions in other states. The mission of the Division of Professions and Occupations is “public protection through effective licensure and enforcement.” One way the Division safeguards consumers is by issuing licenses to fully qualified, competent, and ethical applicants. During the licensing process – and depending on the specific application – the Division may ask whether you have ever been disciplined in any state, arrested, charged, convicted, or pled guilty to a crime. An arrest, subsequent criminal conviction, or disciplinary action is not an automatic disqualification from licensure. Rather, the appropriate board or program will look at the facts surrounding the criminal conduct and disciplinary action in addressing your license application. You should know that licensure is a privilege, not a right. One thing you must do to obtain the privilege is to be complete and accurate in disclosing information on your application. Be sure to list all relevant complaints, disciplinary actions, arrests, charges, or convictions in response to the appropriate licensure questions. Failure to fully and accurately disclose requested criminal history information, alone, could constitute grounds for denial of your application or revocation of your license. When requested, you must include information regarding prior conduct. This remains the case when the conduct is seemingly unrelated to the activities of a profession, and when the conduct involves deferred sentences or judgments. Remember, even following licensure, you are still required to notify your professional licensing board or program about subsequent convictions and disciplinary actions in other states. Please be aware that the Division conducts audits of its licensing database against several criminal and national disciplinary databases. This allows the Division to verify the truthfulness of your application and track subsequent criminal and disciplinary conduct after initial licensure. Keep in mind, your license will not necessarily be revoked, or your application denied, if you have been disciplined, arrested, charged or convicted. But, you will most likely be denied or revoked if you fail to disclose requested information. *The word "license" is used as a general term. While most of the professions and occupations are licensed, others may be registered, certified, or listed. For precise terminology and requirements related to a profession or occupation, please consult the website of the appropriate board or program.

1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800

F 303.894.7693 www.dora.colorado.gov/professions