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Professional Licensing Boards
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Download Forms
| PLEASE NOTE: These Adobe Acrobat forms require the Adobe Reader to view and/or print. If you do not have Adobe Reader installed on your computer, click the "Get Adobe Reader" button on the right to download the reader free of charge from the Adobe website. |
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| Remember to include your e-mail address when completing your application. Providing your e-mail address on your application or other form allows us to send you a confirmation notice when we receive your application. This notice will contain instructions on how to check the status of your application. You will also receive a notification when your license is issued. |
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Form - Application for Licensure |
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Form - Application for Reinstatement |
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Form - Consent Form for Background Investigation |
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Form - Dietitian Continuing Education Audit Form |
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Form - Endorsement Applicants - Verification of License |
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Form - Order Form for License Verifications |
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Form - Petition for Variance or Waiver Request (Rev 10-05) |
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Form - Qualified Alien Status Form |
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Form - Request for Disability Accommodations |
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Form - Request for License Pocket Card |
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Form - Request for Name Change or Address-E-Mail Changes |
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Form - Verification of Employment |
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Reference - 03-19-2021 Dietitians Board Meeting Agenda |
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Reference - CE Report Form - Dietitian Board Renewals |
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Reference - Dietitian Board Policies |
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Reference - Fee Schedule |
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Form - Background Consent |
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Form - Citizenship Affidavit |
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Form - Roster Requests |
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Form - Roster Requests |
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Form - Secure & Verifiable Document Cover Sheet |
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Reference - Complaint Process Details |