Forms

Because of the new Adobe forms technology, it is highly recommended that Internet Explorer 11 or later is used for accessing PDF forms whenever possible. If you must use Chrome or Firefox, please follow the instructions listed below.

Adobe PDF Viewer

PDF forms require an Adobe PDF Viewer browser plug-in. The latest versions of Chrome and Firefox do not support this technology by default. Some additional configurations need to be made to these browsers in order for them to work properly. Depending on your version of Chrome or Firefox, the instructions may vary slightly. When possible, use Internet Explorer 11 or higher. Microsoft Edge is not recommended or supported. In any case, Adobe Reader needs to be installed on your machine. After Adobe Reader is installed, proceed with the instructions below for your specific browser.

Chrome

Replace the Chrome built in PDF viewer so that you can open, view, and save PDF's without issues.

  • Type into the address window of the Chrome browser: chrome://plugins
  • Disable the Chrome PDF Viewer
  • Enable Adobe Reader if it is listed
Firefox

Trying to open PDFs in Firefox could result in an error message that states "This PDF document contains forms. The filling of form fields is not supported."

To get the form to open in Adobe, you need to do the following:

  • Open Firefox
  • Click the Tools menu button
  • Click Options and select Applications
  • Find Portable Document Format (PDF) in the Content Type column
  • In the Action column, change it to Use Adobe Acrobat

Board of Nursing Home Admin - Public Form(s)

SFNTitleSizeDateFillable
60364 INTENT TO APPLY FOR A ND NURSING HOME ADMINISTRATOR LICENSE 420 kb 04/15/2015 Y
60365 STATE BOARD ENDORSEMENT QUESTIONNAIRE 528 kb 04/15/2015 Y
60366 EMERGENCY LICENSE REPORT 400 kb 04/15/2015 Y
60367 CRIMINAL HISTORY RECORD CHECK AUTHORIZATION 370 kb 10/26/2016 Y
60368 APPLICATION FOR INIITAL LICENSURE AS A NSG HOME ADMIN 769 kb 08/12/2016 Y
60369 APPLICATION FOR RENEWAL OF NSG HOME ADMIN LICENSE 673 kb 08/12/2016 Y
60370 APPLICATION FOR LICENSURE AS NGS HOME ADMIN BY ENDORSEMENT 693 kb 08/12/2016 Y
60371 APPLICATION FOR EMERGENCY LICENSURE AS NSG HOME ADMIN 692 kb 08/12/2016 Y