Remedial Completion Form

Have you completed your Remedial Coursework? Please fill out the form below!

Before submitting this form please make sure you have completed ALL Remedial requirements. Submitting this form does NOT get your name automatically sent to the Board of Nursing. After this form is submitted, it takes 72 hours for your coursework to be reviewed by a Nurclex Healthcare Institute Academic Advisor. Once completion has been verified, a Letter of Completion will be written using the information you enter below, so please make sure everything is accurate and spelled correctly. Once your Letter of Completion has been sent to the corresponding Board of Nursing, you will receive an email from us. From that point it takes up to 2 weeks to receive your ATT.If you submit this form but have NOT completed the course requirements, expect an email and call advising you of your missing assignments.
Student Information
Full Name (must match EXACTLY what the Board has on file)*

First NameLast Name
Date of Birth

MonthDayYear
Email*
example@example.com
Did you complete Remediation for LPN or RN?*

LPNRN
To which state Board of Nursing do you want your Letter of Completion to be sent? Board of Nursing *
I have completed ALL the in-person clinicals (48 hours).*

YesNo
I have completed ALL 10 patient scenarios in my VSIM at 85% or higher in all parts (pre-quiz, VSIM, SBAR, post-quiz).*

YesNo
I have completed ALL 29 Passpoint assignments in my Lippincott account.*

YesNo
I have completed at least 2 dosage calculation quizzes at an 85% or higher in my Lippincott Passpoint.*

YesNo
I have completed my diagnostic exam and midpoint exam in Lippincott Passpoint.*

YesNo
Have you completed your Re-exam application to the Board? If not please get this done ASAP! If we send your name and you don't have an application on file, your Letter of Completion will not be reviewed.*

YesNo
Have you completed your reapplication to the State? If not please get this done ASAP! If we send your name and your application is not in you will not be considered for review.*

YesNo **Make sure this is done ASAP or you will elongate your processing time**
Have your reapplied to Pearson? You must pay their $200 fee in order to receive your ATT.*

YesNo **Make sure this is done ASAP or you will elongate your processing time**
Date of Completion of Coursework?

MonthDayYear
Date
Should be Empty: