Name Change Form - Maryland Board of Nursing 2026

Get Form
Name Change Form - Maryland Board of Nursing Preview on Page 1

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.

Definition and Purpose of the Name Change Form - Maryland Board of Nursing

The Name Change Form provided by the Maryland Board of Nursing allows licensees and certificate-holders to officially request a name change on their nursing license or certificate. This form is essential for maintaining accurate and current records with the Board, ensuring that all professional documentation reflects an individual's legal name following changes such as marriage, divorce, or court orders. It ensures continuity and accuracy in identification, which is critical in professional settings.

How to Use the Name Change Form - Maryland Board of Nursing

To effectively utilize the Name Change Form, applicants should complete all sections accurately, including personal information and details of the name change. It's important to ensure that all information is correct, as incomplete or incorrect forms can delay the processing time. Depending on the reason for the name change, applicants must attach required supporting documents before submission. Once completed, the form should be submitted according to the Board's guidelines to ensure timely processing.

How to Obtain the Name Change Form - Maryland Board of Nursing

The Name Change Form is available through the Maryland Board of Nursing's official website. Users can download the form directly in PDF format. It is advisable to check the Board’s website for any updates to the form to ensure compliance with the latest requirements. Alternatively, applicants can contact the Board’s office directly to request a physical copy of the form if they prefer not to download it.

Steps to Complete the Name Change Form - Maryland Board of Nursing

  1. Personal Information Section: Enter your current personal details, including your license or certificate number.
  2. Former Name Section: Provide your previous name as it appears on the current nursing license or certificate.
  3. New Name Section: Enter your new legal name, ensuring it matches the documentation supporting the name change.
  4. Supporting Documentation: Attach copies of legal documents validating the name change, such as a marriage certificate or a court order.
  5. Signature: Sign and date the form, confirming the information provided is accurate to the best of your knowledge.
  6. Submission: Follow the instructions for submission, which may include mailing the form to the Board's office or submitting it online if supported.

Required Documents for Name Change

  • Marriage Certificate: Required if the name change is due to marriage.
  • Divorce Decree: Necessary for individuals changing their name following a divorce.
  • Court Order: Applicable in cases where a legal name change has been authorized by the court.

These documents must be current and official copies to validate the name change request.

Submission Methods for the Name Change Form

Applicants have multiple options for submitting their completed form:

  • Online Submission: If supported, applicants can submit the form and documents electronically through the Board's website.
  • Mail: Printed forms and copies of required documentation can be mailed to the Board’s official address.
  • In-Person: If proximity allows, submissions can also be made in person at the Board’s office.

Key Elements of the Name Change Form - Maryland Board of Nursing

The form includes several crucial sections:

  • Licensee Information: Collecting details such as license number and contact information.
  • Former and New Name: Ensuring accurate update of personal identification.
  • Signature and Date: Certifying the authenticity and accuracy of the change request.

State-Specific Rules and Considerations

Maryland-specific regulations necessitate careful attention when filling out the Name Change Form. It's crucial to follow the state-specific instructions detailed in the form to avoid any non-compliance issues. Each state may have varying requirements for name change procedures, and ensuring Maryland's specific guidelines are met is essential for approval.

Important Terms in the Name Change Process

  • Licensee: A nurse or certificate holder licensed by the Maryland Board of Nursing.
  • Supporting Documentation: Legal documents required to verify and process a name change request.

Understanding these terms and their implications can aid in accurately completing the form.

Examples of Using the Name Change Form

  • Case Study 1: A registered nurse getting married and needing her nursing license updated with her new legal surname.
  • Case Study 2: A nurse recently divorced restoring her maiden name on her professional license.

These examples highlight typical scenarios that necessitate the use of the Name Change Form.

be ready to get more

Complete this form in 5 minutes or less

Get form

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more
ccpa2
pci-dss
gdpr-compliance
hipaa
soc-compliance