Home
Forms Library
EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in

EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in 2025

EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in Preview on Page 1

See details

4.8 out of 5

109 votes

The document is an Employer Quarterly Report form for a nurse on probation, issued by the Indiana State Board of Nursing. It requires the employer to provide detailed information about the nurse's attendance, performance, and adherence to policies as part of the probationary terms. The report includes sections for evaluating the employee's strengths and areas for improvement, medication duties, and compliance with the Board Order. The completed form must be submitted to the Indiana State Board of Nursing.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION in the editor.
Begin by entering the reporting period dates in the designated fields, ensuring accuracy for both 'From' and 'To' dates.
Fill in the employee's name, license number, employing facility name, and contact details. This information is crucial for identification.
Provide details about attendance by entering the number of hours practiced, days absent, and days tardy since the last report. Use the text box to explain any absences or tardiness.
Answer all performance-related questions honestly. Indicate any changes in position or responsibilities and address any identified performance deficiencies.
Evaluate the employee using the provided factors. Mark 'E', 'S', or 'NI' for each category based on your assessment.
Complete the medication duties section if applicable, detailing any restrictions and how often medication records are reviewed.
Finally, ensure that the supervisor signs and dates the form before submission. You can easily add a signature using our platform’s signing feature.

Start filling out your EMPLOYER QUARTERLY REPORT today for free with our platform!

See more EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in versions

We've got more versions of the EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in form. Select the right EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (109 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How far back does a nursing background check go?

How far back a nursing background check goes depends on the type of screening and local laws. Generally, most criminal background checks cover at least seven to ten years.

Can you be a nurse if you have health issues?

Yes you can. You need to keep your symptoms under control though, and be aware in advance that nursing school and being a nurse will cause you a lot of stress and anxiety.

What things disqualify you from being a nurse?

Significant offenses or violations can be a red flag and a potential hindrance to your licensing, such as drug offenses, physical or sexual abuse charges, and theft. Major felonies, and sometimes even misdemeanors, could disqualify you from obtaining a nursing license.

How long is probation for nurses?

Probation: Probation periods can last anywhere from one to several years. Once probation is successfully completed, the disciplinary action is often noted as completed but remains on the nurses permanent record. Suspension: The length of a suspension can vary widely.

What disqualifies someone from being a nurse?

Importance of Background Checks Significant offenses or violations can be a red flag and a potential hindrance to your licensing, such as drug offenses, physical or sexual abuse charges, and theft. Major felonies, and sometimes even misdemeanors, could disqualify you from obtaining a nursing license.

What is the probation period in nursing?

Probation means a period of six (6) months from the day upon which an employee is first appointed or a period of three (3) months after an employee has been transferred or promoted.

Which is the most frequent reason for revocation or suspension of a nurses license?

Textbook Expert-Verified. The most common reason for revocation or suspension of a nurses license is Alcohol or drug abuse. This can severely affect patient care and safety. The nursing profession actively monitors and addresses substance misuse as part of maintaining professional integrity.

What makes you ineligible to be a nurse?

Common disqualifying offenses include convictions for violent crimes, sex offenses, drug offenses, fraud, theft, and patient, child, or elder abuse. In some states, certain offenses automatically disqualify candidates from being a nurse.

EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in 2025

Here's how it works

How to use or fill out EMPLOYER QUARTERLY REPORT FOR A NURSE ON PROBATION - in with our platform