TX HHS Form 5518-NFA. Provisional Licensure Questionnaire

The TX HHS Form 5518-NFA, Provisional Licensure Questionnaire, is a crucial document for individuals seeking provisional licensure as a Nursing Facility Administrator (NFA) in the state of Texas. This form helps solve the problem of verifying an applicant's education, internship, exam scores, and courses in the four domains of the National Association of Long-Term Care Administrator Boards (NAB). The questionnaire is typically completed by applicants who need to demonstrate their qualifications for provisional licensure.

The form requires applicants to provide personal information, including name, social security number, date of birth, email address, and phone number. Additionally, it asks about the applicant's employment history, specifically requiring information on at least one year of experience as an administrator of record in their state. The questionnaire also includes a section for the provisional license sponsor, who will support the applicant during the provisional licensure process.

Key features of this form include the requirement to submit proof of education and qualifications if the state that issued the applicant's original license cannot verify these items. Applicants must also authorize the release of their licensure information from their current state of licensure. The TX HHS Form 5518-NFA is an essential tool for NFA applicants seeking provisional licensure in Texas.

• The form is used by individuals seeking provisional licensure as a Nursing Facility Administrator (NFA) in the state of Texas.
• The questionnaire helps verify an applicant's education, internship, exam scores, and courses in the four domains of the National Association of Long-Term Care Administrator Boards (NAB).
• Applicants must provide personal information, employment history, and authorization for the release of licensure information.