Healthy Communities

ARSBN - Forms

Online Services

Nursing Roster Request

Applications must be submitted through creation of a nurse portal account.

Criminal Background Checks and Fingerprint Card Request System

 

Read all information and choose fingerprint method below.

Arkansas law requires criminal background checks. A state and federal criminal background check is required if they are not already on file with Arkansas State Board of Nursing (ASBN) within the last 12 months of application. Background checks from other agencies are not accepted.

Fees associated with conduction of the state and federal criminal background checks are at the applicant’s expense and are paid within this online system. A fee of $36.25, in addition to a processing fee, is required to process the state and federal criminal background checks. After submission of your request, you will receive two automatically generated email notifications, an Arkansas GovPay receipt and Request Acknowledgement. These emails will be sent to the email address that you provide.

FEES ARE NONREFUNDABLE

DO NOT, UNDER ANY CIRCUMSTANCES, CONTACT THE ARKANSAS STATE POLICE OR THE FBI ABOUT THE STATUS OF YOUR CRIMINAL BACKGROUND CHECKS.

Arkansas State Police Criminal Background Check

The State Criminal Background Check information is obtained within this system; no additional form is completed or submitted to Arkansas State Board of Nursing or the Arkansas State Police.

Federal Criminal Background Check

The Federal Criminal Background Check requires that your fingerprints are used to check the criminal history records of the Federal Bureau of Investigation (FBI). Fingerprint information is obtained in one of two ways, EITHER by 1) Arkansas Live Scan fingerprint scanning or 2) Ink based fingerprint card. Refer to the respective instructions contained herein.
Note: Out of state Endorsement applicants will need to either come to Arkansas to have Federal fingerprints live scanned or request the Ink based fingerprint card method.

1) Arkansas Live Scan fingerprint scanning

Arkansas Live Scan is the ONLY vendor approved to conduct digital scanning of fingerprints for Arkansas State Board of Nursing. Obtaining fingerprints via Arkansas Live Scan is a wonderful option with significant benefits such as:

Considerably faster return of results - typically within a week as compared to 4-6 weeks or longer with ink based finger printing;
High quality fingerprints ensure accuracy and minimize mistakes; and
Efficient images with no messy ink process; no fingerprint card is required

There is an additional $15.00 fee that each applicant pays to Arkansas Live Scan when having a live scan conducted.

Click here to download instructions for Arkansas Live Scan fingerprinting scanning.

2) Ink based Fingerprint Card

To have your fingerprints obtained via the ink based option you MUST use the fingerprint card provided by the Arkansas State Board of Nursing. The fingerprint card will be mailed to you for completion and submission for the federal criminal background check. Arkansas State Board of Nursing typically receives results in 4 – 6 weeks; at times it may be longer.

When you request a fingerprint card through this system, it will be mailed to the address you provide. You must use the fingerprint card provided by ASBN. Refer to the instructions for directions on how to complete and mail the fingerprint card.

Click here to download instructions for obtaining, completing and submitting an ink based fingerprint card.

 

REQUEST CRIMINAL BACKGROUND CHECKS (CBCs) & DETERMINE FINGERPRINT COLLECTION METHOD

Choose one method.

Downloads & Resources
Criminal Background Check Instructions
Diabetes Self Management Educator Application and Requirements
Diabetes Self Management Educator Renewal Application and Instructions
Education Department Online Application Additional Documents Cover Page
Employment Verification Form
Individual Offering Approval Form
Multistate Nursing License Application and Instructions
Program RN/PN Verification
Special Accommodation for NCLEX® Exam Information and Request Form
Disciplinary Forms
Aftercare Meetings Report
Employer Acknowledgement
Enforcement Treatment Provider Report
Medication Report
Performance Evaluation Report
Personal Report
Reinstatement Current Medication List
Reinstatement Personal Report
Reinstatement Request Form
Work History Form

Public Health Accrediation Board
Arkansas Department of Health
© 2017 Arkansas Department of Health. All Rights Reserved. www.healthy.arkansas.gov
4815 W. Markham, Little Rock, AR 72205-3867
1-800-462-0599