Reporting a Change in NP Client Population

This form is for you if you are an NP who needs to report a change in your client population. 

We define a change of population as moving from the client population that you are formally educated in and for which you have passed the applicable exam, to a client population for which you have not been educated or passed the applicable exam.   

You are required to report to the NSCN CEO your intention for change in population and receive approval from the Registration and Licensing Committee prior to providing care to a client population for which you have not completed education or passed the applicable licensure exam. This committee will review the application and may determine what, if any, additional education and exams are required in order for you to provide nursing services to the new client population.

You are not required to report to NSCN if you are providing nursing services to clients within the same population for which you were educated in and passed the applicable exam. For example, a “Family/All Ages” NP who passed the CNPE and is changing employment from a community clinic to an acute care facility does not need to submit documentation to NSCN.

Please complete the form below to request a change in NP client population. 

As a result of the Nursing Act, you are no longer not required to report if you are moving to a different practice setting if it is within the same stream of practice (e.g. a Family/All Ages NP who moves from a community clinic to an acute care facility). This type of client population change will be managed through your employer orientation to the new position.

NP Change of Client Population Report Form

Nurse practitioners who wish to apply for a change of client population will submit their request to the Registration and Licensing Committee using the following form:

Name
Focus of Education in Initial NP Program (select appropriate option):
Requesting to Change to the Following Client Popuation (select appropriate option):