N.H. Admin. Code § Resp 302.04

Current through Register No. 45, November 7, 2024
Section Resp 302.04 - Required Documents

Applicants for initial licensure to practice respiratory care shall provide, or arrange for the board to receive, the following documents supporting their applications:

(a) A recent passport size, 2" x 2", original head shot photograph;
(b) On a separate sheet, a detailed report of the relevant circumstances if any of the answers to questions (f)(1) through (f)(6) on part one of the application form is in the affirmative;
(c) On a separate sheet, a detailed report of the relevant circumstances if any of the answers to questions (i)(1) through (i)(5) on part 2 of the application form is in the affirmative;
(d) An official letter of verification sent directly to the board from every state which has issued a license or other authorization to practice stating whether:
(1) The license or other authorization is or was, during its period of validity, in good standing, and
(2) Whether any disciplinary action was taken against the license or other authorization to practice;
(e) If the applicant met the educationalrequirements set forth in Resp 303.02(a) after July 31, 1977, an official transcript from the respiratory care educational program or school:
(1) Mailed directly to the board by the educational program or school; or
(2) Submitted by the applicant in an envelope sealed by the educational program or school in such a manner that it would be evident to the board if the envelope had been opened;
(f) An authenticated copy of one of the following certifications:
(1) Certification as an inhalation therapy technician, whether by that name or a name later given by NBRC to the same certification; or
(2) Certification as a registered inhalation therapist, whether by that name or a name later given by NBRC to the same certification;
(g) An original, not a photocopy, of a criminal offender record report:
(1) Issued by each state where the applicant has resided or been licensed within the past 6 years, providing that such state will:
a.Send the report to the board; or
b.To the applicant for forwarding to the board;
(2) Covering the applicant under his or her name and any aliases; and
(3) Dated within 6 months preceding the application for licensure;
(h) Original, not photocopied, letters of reference meeting the requirement of Resp 302.05 and written by 2 professional colleagues who are:
(1) Not related in any of the following ways to the licensee:
a.Spouse or civil union partner;
b.Parent, step parent, parent in law, or step parent in law;
c.Natural, foster or adopted child, or stepchild; or
d.Sibling, brother-in-law, or sister-in-law;
(2) Familiar with the applicant's character, professional competence and skills in respiratory care; and
(3) From individuals who are familiar with the applicant's professional abilities;
(i) A resume presenting a chronologically organized account of the applicant's experience in respiratory care including:
(1) Each separate experience in paid or volunteer work as a direct care provider of respiratory care, an educator in respiratory care, a respiratory care administrator or a respiratory care consultant and whether the experience was part- time or full-time;
(2) The period of each separate experience described by its beginning and ending dates; and
(3) The physical address of each experience.
(j) If subject to conditional licensure pursuant to Resp 305.02, a completed supervision form as described in Resp 305.07; and
(k) If Resp 305.02(a)(1) is applicable, the following proofs of having met the competency requirements of Resp 305.03:
(1) For the courses described in Resp 305.03(b)(1) and (2), proofs of attendance showing:
a.The name of the applicant;
b.The name or main topic of the course;
c.The beginning and ending dates of the course;
d.The duration of the course in hours; and
e.The signature of a representative of the course sponsor or provider; and
(2) For the NBRC self-assessment examination described in Resp 305.03(b)(3), the applicant's scores sent directly to the board by NBRC.

N.H. Admin. Code § Resp 302.04

#8427, eff 9-10-05; ss by #9067, eff 1-11-08; ss by #9957-A, eff 7-16-11; ss by #10184, eff 9-18-12; ss by #10405, eff 8-30-13