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  1. Click ‘Get Form’ to open it in the editor.
  2. In Section 1, select all applicable types of requests: Legal Name Change, Change of Mailing Address, or Change to Contact Information.
  3. Refer to Section 2 for acceptable documentation. If requesting a legal name change, ensure you attach proof such as a marriage license or court records.
  4. Complete Section 3 with your new contact information. Fill in your last name, first name, date of birth, and mailing address accurately.
  5. Provide your primary and secondary phone numbers and email address. Indicate if any numbers are unlisted.
  6. Sign and date the form at the bottom to authorize the updates before submitting it via mail, fax, or email.

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Er Nurse Salary in Oregon Annual SalaryWeekly Pay Top Earners $141,676 $2,724 75th Percentile $106,300 $2,044 Average $91,706 $1,763 25th Percentile $66,600 $1,280
Approximately 4-8 weeks for a license upon receipt of all required materials, but the Oregon Board of Nursing does not commit to a definitive timeline.