Nursing Course Registration Form

Nurses with BON ordered classes may skip this portion.

Nurse Refreshers please read:

1. If you are a previously licensed Texas with in-active or delinquent license and no other issues you may proceed to next section.

2. If you are a formerly Texas licensed nurse with a previous action on your license but, you have received BON permission to proceed you may move forward to registeration. If you have not received BON permission STOP you need a consult as well.

3. If you are endorsing from out of state and your license is in-active or active there you may proceed with registration.

4. If you are endorsing from out of state and your license in the other state was revoked, surrendered, suspended, cancelled or otherwise restrictied STOP. You need to request an appointment with the Director of Education for a consult (In person or virtual) on your case to ensure of the steps in your process and bring or email your order in advance of the appointment.

5. If you have an elgilibility issue (legal issue, mental health, impairment, etc.) and you have received BON permission you may proceed. If you have not received BON permission. STOP you need a consult with the Director as well.

A consult is $100 and you can be scheduled within a week of paying your fee. All information discussed in confidential and we have helped many nurses with various issues return to active clinical practice. Please email cynthia.carradine@phesonline.com to schedule DOE consult day and time.

This process is put in place not to hinder you but, to assist in ensuring you do not waste time, money or resources and understanding the requirements for your particular situation.

Name

First NameLast Name

RN or LVN/LPN*

RNLVN/LPNAPRN

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail*

example@example.com

Preferred Phone Number*

Area CodePhone Number

Course Option 1*

If Refresher no need to choose others. For remediation nurses that need more than 1 course go to the next course option and choose 2nd course

Course Option 2

For more than 2 courses go to the next course option and choose 3rd course

Course Option 3

Course Option 4

Texas or other License # and state if not Texas

FOR REFRESHERS ONLY!! If you already have your CPR, BON Permit and any other documents you want to share on registration feel free to upload here.

Browse Files

Questions or Comments

I understand that I must do all courses and that if there is any course I cannot I will notify the instructor. I agree to protect the copyright of all curriculums and not share the online access or class material with any person or entity. I agree to complete all coursework myself and seek instructor support for any questions I have. I understand that Verification of Course Completion or Continuing Education Certificates will not be given until all payments are completed. I understand that it is recommended that I begin the clinical component, if needed; within 45 days of last class and that clinical hours cannot be done until all coursework is completed. If I have concerns about my ability to do this I will discuss with an instructor prior to beginning coursework or as soon as possible. All payments for courses/programs must be paid off within 3 months. If you need an extension, please discuss with us. Deposit and fees are transferrable to another class or date but, not refundable.

Signature agreeing to above*

Nurse Registration Form