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Application for Licensure

The Texas Board of Nursing approves students to take the licensure exam. Certain criminal convictions prohibit applicants from applying to take the exam. Acceptance to the program does not guarantee graduation or approval to take licensing exam.
The Texas Board of Nursing determines eligibility requirements for applicants for the initial licensure by examination. If eligibility issues arise, the eligibility process can take up to 6 months or longer.
All candidates for licensure will be required to answer the following questions:

1. *For any criminal offense, including those pending appeal, have you:

A. been arrested or have any pending criminal charges?
B. been convicted of a misdemeanor?
C. been convicted of a felony?
D. pled nolo contendere, no contest, or guilty?
E. received deferred adjudication?
F. been placed on community supervision or court-ordered probation, whether or not adjudicated guilty?
G. been sentenced to serve jail or prison time? court-ordered confinement?
H. been granted pre-trial diversion?
I.   been cited or charged with any violation of the law?
J.   been subject of a court-martial; Article 15 violation; or received any form of military judgment/punishment/action?

(You may only exclude Class C misdemeanor traffic violations or offenses previously disclosed to the Texas Board of Nursing on an initial licensure or renewal application.)

NOTE: Expunged and Sealed Offenses: While expunged or sealed offenses, arrests, tickets, or citations need not be disclosed, it is your responsibility to ensure the offense, arrest, ticket or citation has, in fact, been expunged or sealed. It is recommended that you submit a copy of the Court Order expunging or sealing the record in question to our office with your application. Failure to reveal an offense, arrest, ticket, or citation that is not in fact expunged or sealed may subject your license to a disciplinary order and fine. Non-disclosure of relevant offenses raises questions related to truthfulness and character.  (See 22 TAC §213-27)

NOTE: Orders of Non-Disclosure: Pursuant to Tex. Gov’t Code § 552.142(b), if you have criminal matters that are the subject of an order of non-disclosure you are not required to reveal those criminal matters on this form.  However, a criminal matter that is the subject of an order of non-disclosure may become a character and fitness issue. Pursuant to Gov’t Code chapter 411, the Texas Nursing Board is entitled to access criminal history record information that is the subject of an order of non-disclosure. If the Board discovers a criminal matter that is the subject of an order of non-disclosure, even if you properly did not reveal that matter, the Board may require you to provide information about any conduct that raises issues of character and fitness.

2.  *Are you currently the target or subject of a grand jury or governmental agency investigation?

3.  Has any licensing authority refused to issue you a license or ever revoked, annulled, cancelled, accepted surrender of, suspended, placed on probation, refused to renew a professional license, certificate or multi-state privilege held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you?

4. *In the past five (5) years, have you been diagnosed with or treated or hospitalized for schizophrenia or psychotic disorders, bipolar disorder, paranoid personality disorder, antisocial personality disorder, or borderline personality disorder which impaired or does impair your behavior, judgment, or ability to function in school or work? (You may answer “No” if you have completed and/or in compliance with TPAPN for mental illness OR you’ve previously disclosed to the Texas Board of Nursing and have remained compliant with your treatment regime and have had no further hospitalization since disclosure.)

5. *In the past five (5) years, have you been addicted to or treated for the use of alcohol or any other drug?

*Pursuant to the Occupations Code §301.207, information, including diagnosis and treatment, regarding an individual’s physical or mental condition, intemperate use of drugs or alcohol, or chemical dependency and information regarding an individual’s criminal history is confidential to the same extent that information collected as part of an investigation is confidential under the Texas Occupations Code §301.466. If you are licensed as an LVN in the State of Texas and are currently participating in the Texas Peer Assistance Program for Nurses you may answer “NO” to questions #4 and #5.

NOTE: IF YOU ANSWER “YES” TO #1-#5, PLEASE REFER TO
“APPLICATION INSTRUCTIONS” FOR MORE INFORMATION.

ATTESTATION STATEMENT
I, the Nurse Applicant whose name appears with this Application, acknowledge this is a legal document. I understand that no one else may submit this form on my behalf and that I am accountable and responsible for the accuracy of any answer or statement on this form.  I understand that it is a violation of the 22 Texas Administrative Code, §§ 217.12 (6)(1) and the Penal Code, sec 37.10, to submit a false statement to a government agency; and I consent to release of confidential information to the Texas Board of Nursing and further authorize the Board to use and to release said information as needed for the evaluation and disposition of my application. I understand that if I have any questions regarding this affidavit I should contact an attorney or the appropriate professional health provider.  I will immediately notify the Board if at any time after signing this affidavit I no longer meet the eligibility requirements.

For information or guidance in this process to determine eligibility for licensure by examination, contact the Board of Nurse Examiners at 512-305-7400 or go to the web site:  http://www.bon.state.tx.us/index.html

 

 

Page last updated: 9-2-2016