Provisional Permit Application Forms - Office of the Professions 2026

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  1. Click ‘Get Form’ to open the Provisional Permit Application Form in our editor.
  2. Begin with Section I, where you will enter your personal information. Fill in your Social Security Number, Birth Date, and Name. Ensure that you provide a valid daytime phone number and email address.
  3. Complete the mailing address section accurately. Remember to indicate whether it is a home or business address, as this information will be public.
  4. In item 7, specify the name of the Clinical Laboratory Director or Principal Researcher who will complete Section II. Choose between A or B based on your training experience.
  5. After filling out Section I, send the entire form to the designated Clinical Laboratory Director/Principal Researcher for completion of Section II.
  6. Once Section II is completed and signed by the director/researcher, ensure that all pages are sent directly to the Office of the Professions at the specified address.

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To be licensed as a clinical laboratory technologist in New York State you must meet all requirements, including: submit the application and fee for initial licensure; be of good moral character; be at least 18 years of age; meet education or alternative to education requirements; and. meet examination requirements.
All Appearance Enhancement (Business, Area Renter, Cosmetology, Esthetics, Nail Specialty, Natural Hair Styling and Waxing Operator) and Barber (Shop Owner, Area Renter, Apprentice and Operator) licenses must be renewed online through an online account.
Renewal. Once you receive your license you will need to renew it every two years. To renew, you must pay a fee and submit documentation of continuing education.
To renew your existing Clinical Laboratory Technologist license registration, visit and follow the instructions for registration renewal. This is an application for a new Clinical Laboratory Technologist license.
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