November 13,  2021 - ALS Psychomotor Exam-Great Plains, Lawton,  OK

ALS PSYCHOMOTOR EXAM REGISTRATION

Complete ALS Psychomotor Exam Registration Form online.
NOTE: It is important that you complete all fields and electronically sign/date the online form in order for your registration to be accepted.

APPLICATION FOR LICENSUREDownload and complete the licensure application and Affidavit of Lawful Presence.
  1. Mail the licensure application, Affidavit of Lawful Presence, and the appropriate fees to:
                 OSDH – Financial Management Office
                 P. O. Box 268823
                 Oklahoma City, OK 73126-8823 

NOTE: All documents must be received by OSDH at least three weeks prior to your exam date.

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* 3. If this is a partial retest, what skills are you retesting?

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* 4. Candidate First Name:

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* 5. Candidate Middle Initial:

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* 6. Candidate Last Name:

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* 7. PATT Number:

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* 8. Address

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* 9. Training Institution:

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* 10. Electronic Candidate Signature:
(By typing your name below, you understand that you are electronically signing this document and are agreeing to all of the policies and conditions set forth.)

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