REQUEST RELEASE FORM 2026

1. Click ‘Get Form’ to open the REQUEST RELEASE FORM in the editor.
2. Begin by filling out the 'Certified Individual Information' section. Enter your name, address, city, state, zip code, email address, certification expiration date, and phone number as they appear on your certification documentation.
3. Provide your signature by checking the box that grants permission to the RNCB to release verification of your certification. If applicable, indicate if a background check release has been signed.
4. Next, complete the 'Employers/Verification Agencies Information' section. Fill in the institute or agency name, attention individual or department, city, state, zip code, email address, fax number, and phone number.
5. Review all entered information for accuracy before submitting. Ensure you understand the $25 verification fee and payment instructions provided at the end of the form.

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