Clinical Laboratory Personnel Qualifications Instructions
This document provides detailed qualifications, instructions, and requirements for clinical laboratory personnel licensure, temporary licenses, and trainee licenses in Louisiana. It includes steps for notarization, submission of various forms, and verification of other licenses. Ensure all information is accurate and complete to avoid delays or additional fees.
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How do I fill this out?
To fill out this form, begin by gathering all the required documents and information. Carefully read and follow the instructions for each section to ensure accuracy. Notarize and submit the completed form along with the necessary fees and supporting documents.
How to fill out the Clinical Laboratory Personnel Qualifications Instructions?
1
Gather all necessary documents and information.
2
Carefully read the instructions for each section.
3
Fill out each section accurately.
4
Notarize the required documents.
5
Submit the completed form with fees and supporting documents.
Who needs the Clinical Laboratory Personnel Qualifications Instructions?
1
Applicants for clinical laboratory licensure need this form to apply for licensure.
2
Graduates applying for temporary laboratory licenses need this form to register for certification exams.
3
Students and returning practitioners applying for trainee licenses need this form for supervised work applications.
4
Non-U.S. citizens applying for laboratory positions need this form to verify visa status and authorization.
5
Individuals applying for laboratory licensure under a different name need this form to document name changes.
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What are the instructions for submitting this form?
To submit this form and required documentation, mail your completed application along with notarized copies, fees, and supporting documents to the Louisiana State Board of Medical Examiners at 630 Camp Street, New Orleans, LA 70130. Alternatively, email the required materials to lsbmecbc@lsbme.la.gov or call (504) 568-6820 for further instructions. Ensure all fees are paid via check or money order and included with your submission.
What are the important dates for this form in 2024 and 2025?
Ensure to submit your application and required documents before the deadline to avoid any delays or additional fees.
What is the purpose of this form?
The purpose of this form is to provide clear and detailed instructions for individuals applying for various types of clinical laboratory licensure in Louisiana. It outlines the necessary qualifications, documentation, and steps to complete the application process successfully. By following the provided instructions, applicants can ensure their submissions are accurate and complete, helping to expedite the processing of their applications.
Tell me about this form and its components and fields line-by-line.
- 1. Oath or Affirmation: A notarized form that must be accompanied by a sworn affidavit for any 'yes' answers.
- 2. Third Party Authorization: A notarized form authorizing LSBME to obtain information from third parties.
- 3. Fees: A section detailing the non-refundable fees to be paid via check or money order.
- 4. Certificate of Dean/Registrar: A notarized form completed by the applicant and the educational institution.
- 5. Verification of Other Licenses: Form or instructions for verifying other health care-related licenses.
- 6. Criminal Background Check: Instructions for conducting a background check as part of the application process.
- 7. Additional Requirements: Information on notarized documents required for various citizenship statuses.
- 8. Specific Qualifications and Instructions: Detailed qualifications and instructions for different types of clinical laboratory licensure.
What happens if I fail to submit this form?
Failure to submit this form accurately and completely may result in delays or additional fees. Ensure all information is correct to avoid complications.
- Delayed Processing: Incomplete or incorrect submissions can lead to delays in processing your application.
- Additional Fees: Failure to disclose necessary information may result in additional processing fees.
- Rejected Application: Incorrect or incomplete forms may result in your application being rejected.
How do I know when to use this form?
- 1. Clinical Laboratory Scientist Licensure: Submit this form to apply for general or specialist clinical laboratory scientist licensure.
- 2. Temporary License: Use this form to apply for a temporary license if you are a recent graduate scheduled for a certification exam.
- 3. Trainee License: Complete this form if you are a student or returning practitioner applying for a trainee license.
- 4. Verification of Other Licenses: Use this form to verify other health care-related licenses you hold.
- 5. Criminal Background Check: Include this form as part of the background check process for your application.
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Yes, save the edited document and return to it later to complete the form.
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