Committee for Clinical Perfusionist
When completing the initial application process, you will be required to submit an official transcript from the institution where you completed your education. The transcript must be mailed directly from the educational institution to the board office located at 665 Mainstream Drive, Nashville, TN 37243 oe e-mailed to Medical.Health@tn.gov.
► Applying for initial licensure from your professional licensing board has become a bit easier. The Department of Health has implemented an online application process that will allow all health care professionals to apply online for an initial license and complete (and update as necessary) a practitioner profile mandatory for certain professions. The process is user friendly and convenient and even allows you to pay for your initial application utilizing a credit card, debit card or e-check. You will also be able to upload many of the documents required to complete your initial application! Please go to the initial application link below to begin the online process.
- Declaration of Citizenship (PH-4183)
- Declaration of Eligibility for Expedited Licensure Process for a Military Member (PH-4279)
- Declaration of Eligibility for Expedited Licensure Process for a Spouse of a Military Member (PH-4280)
- Request for Duplicate License
- Application Instructions for Licensure as a Clinical Perfusionist (PH-3739)
- Renewal Application/Instructions
- Name and Address Change Request
- Affidavit of Retirement From Practice in Tennessee (PH-3460)
- Application Instructions for Licensure Reinstatement (PH-3556)