Address Name Change Form – Fill Out and Use This PDF

Address Name Change Form PDF Details

In the dynamic professional landscapes of healthcare and nursing, ensuring up-to-date records with regulatory bodies is paramount. Within this framework, the Address and/or Name Change Request Form provided by the Oregon State Board of Nursing (OSBN) serves as a key administrative tool for nursing practitioners in Oregon to maintain accurate licensure and contact information. This meticulous process, notably devoid of any associated fees, necessitates the use of black or blue ink for legibility or the election of a digital completion option prior to physical signature and submission through mail, email, or fax. The form carefully distinguishes between various kinds of updates — from mailing addresses and contact information adjustments to more intricate changes involving one's legal name. The latter requires submission of specific legal documents as proof, including marriage certificates, divorce decrees, or other court records endorsing a legal name change, thus ensuring the documentation accurately reflects the individual's current legal standing. It further simplifies the address or contact information updates by not necessitating any additional documents, thus streamlining the process. Importantly, the form underlines the necessity for practitioners to keep their information current per Oregon Administrative Rule, impacting how they receive critical correspondence regarding licensure renewals and other essential notifications. With clear instructions and specified documentation requirements, the form not only facilitates a smoother transition for personal record adjustments but also underscores the importance of regulatory compliance in nursing practice.