NAC630A.400. Application for certificate.

     1. An applicant for a certificate to practice as an advanced practitioner of homeopathy must submit to the Board a notarized application on a form furnished by the Board. The form may be obtained from the Office of the Board or from the Internet website of the Board.

     2. The applicant must include on the application, or in an attachment thereto, any information required by the Board, including, without limitation:

     (a) His or her place and date of birth;

     (b) His or her social security number as required pursuant to NRS 630A.246;

     (c) The address and telephone number of his or her place of residence and place of business;

     (d) Proof that the applicant meets the qualifications required by the Board pursuant to subsections 1, 2 and 3 of NAC 630A.420;

     (e) A list describing any license or certificate that the applicant has earned which required the completion of medical or professional training or which authorizes him or her to provide medical or professional services;

     (f) A statement disclosing whether the applicant has ever been convicted of a crime;

     (g) A statement disclosing whether any disciplinary action has ever been taken against the applicant in his or her capacity as the holder of a license or certificate which authorizes him or her to provide medical or professional services;

     (h) A photograph of the applicant which was taken not more than 60 days before the application is submitted;

     (i) A complete set of the applicant’s fingerprints on a form which is furnished by the Board, along with the written consent of the applicant for the Board to forward the fingerprints to a law enforcement agency for a report on the criminal history of the applicant; and

     (j) A letter of recommendation from:

          (1) A homeopathic physician who is actively engaged in the practice of homeopathic medicine in this State; and

          (2) Two persons who have known the applicant for at least 1 year.

     3. The applicant must submit, with the application, the application fee required pursuant to NRS 630A.330. The application fee is nonrefundable.

     (Added to NAC by Bd. of Homeopathic Medical Exam’rs, eff. 10-25-96; A by R105-03, 9-24-2003; R217-08, 12-17-2008)