Applications and Documents

South Dakota Board of Nursing Facility Administrators forms are available as ADOBE PDF documents.

Licensure

• Application for Initial Licensure
  • Purchase information for the Administrator-in-Training Manual from the National Association of Long Term Care Administrator Boards (look for PB-04: NAB Administrator-in-Training Domains of Practice Internship Manual by James E. Allen and Philip S. Brown)
• Application for Reciprocal Licensure
• Application for Inactive Status of License
• Application to Reactivate License
• Examination Registration | South Dakota Administrative Rule 44:04 (covered in the state exam)

• Verification of Licensure - Request Form

Preceptors

• Application for Certified Preceptor
• Preceptor and Emergency Permit Holder Agreement
• Preceptor - Emergency Permit Holder Monthly Reporting Form
• Preceptor and Administrator-in-Training Agreement

Emergency Permits

• Request for an Emergency Permit
• Request for an Emergency Permit Renewal

Continuing Education

• Continuing Education Program Approval Form

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