Arkansas inactive form board nursing 2026

1. Click ‘Get Form’ to open the Arkansas Inactive Request Form in our editor.
2. Begin by filling in your full name, including first, middle, and last names. Ensure accuracy as this information is crucial for identification.
3. Provide your mailing address, including street, city, state, and zip code. This will be used for any correspondence regarding your request.
4. Enter your Social Security number and telephone numbers (work, home, and cell) to ensure the Board can reach you if necessary.
5. Indicate the specific license(s) you wish to place on inactive status by entering the corresponding license numbers for RN, LPN, LPTN, Advanced Practice Nurse, or Nurse Practitioner.
6. Review the attestation statement carefully. By signing and dating the form, you confirm that all provided information is accurate and that you understand the implications of placing your license on inactive status.

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