Intake form

Tell us where you are in the process

Everything a state board of nursing typically asks for, in one place. Nothing is shared outside our licensure team.

Form completion6%

Personal information

Full legal name*

Any previous or maiden name

Email*

Phone (with country code)*

Date of birth*

Country of citizenship*

Country where you live now*

Nursing education

Nursing school*

Country of your school*

Program type*

Graduation year*

Total clinical hours (if known)

Current license & experience

License / registration number (if you have it)

Country that issued your license*

License status*

Years of nursing experience

US application & exam plan

State you are applying to*

Application route*

Credential evaluation status*

English exam status*

English exam score (if taken)

Preferred test center city / country

When would you like to sit the exam?

Previous NCLEX attempts

Anything else we should know?

How you would like to work with us

No fee for this option, and your checklist appears as soon as you submit the form.

I confirm these details are accurate and BridgeRN may use them to guide my licensure steps. We never submit an application on your behalf without your written approval.