護士變更注冊申請審核表完整版

護士變更注冊申請審核表完整版NursingRegistrationChangeApplicationFormInstructions:1.Thisformisforapplyingforachangeinnursingregistration.2.Fillouttheformininkwithclearhandwritingandtruthfulinformation.3.Sections1-4aretobefilledoutbytheapplicant,sections5-6byrelevantmedicalinstitutions,andsection7bytheregistrationauthority.4.UseArabicnumeralstofilloutdates.5.Fortheapplicant'seducation,filloutthehighestdegreeattainedinnursingormidwifery.6.Fortheapplicant'shealthstatus,indicatewhethertheyareingoodhealth,haveachronicillness,orareinfairhealth.7.Fortheapplicant'sworkcategory,indicatewhethertheyworkinclinicalnursing,nursingadministration,preventivehealthcare,orother.8.Fortheapplicant'scurrenttechnicaltitle,indicatewhethertheyareanurse,nursingsupervisor,chiefnursingofficer,deputychiefnursingofficer,chiefnursingofficer(unrated).9.Attacharecent,passport-stylephoto.NursingRegistrationChangeApplicationFormDate:Year/Month/Day1.ApplicantInformationName:DateofBirth:IDNumber:Graduatedfrom:Major:Education:GraduationDate:ProfessionalExperience:Degree:NursingLicenseNumber:Gender/Nationality:DateofNationality:LengthofStudy:HealthStatus:Date:2.Applicant'sOriginalWorkplaceInformationNameofOriginalWorkplace:AdministrativeDivision:PostalCode:Department:WorkCategory:WorkPeriod:TechnicalTitle:Position:Province/City/County:FromYear/Month/DaytoYear/Month/Day3.Applicant'sIntendedWorkplaceInformationNameofIntendedWorkplace:AdministrativeDivision:PostalCode:Department:WorkCategory:Province/City/County:TechnicalTitle:Position:4.Applicant'sSignature5.OpinionofOriginalWorkplace(tobefilledoutbyworkplace)Opinion:Agree□Disagree□SignatureofLegalRepresentative(orAuthorizedRepresentative):Date:Year/Month/Day6.OpinionofIntendedWorkplace(tobefilledoutbyworkplace)Opinion:Agree□Disagree□SignatureofLegalRepresentative(orAuthorizedRepresentative):Date:Year/Month/Day7.OpinionofRegistrationAuthority(tobefilledoutbyregistrationauthority)Approved