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Provider Applications
Any individual, institution, organization, or agency in Indiana responsible for the overall development, implementation, evaluation, and quality assurance of continuing nursing education is eligible to seek approval as a provider. A first-time applicant must have had three (3) individual activities reviewed and approved by the ISNA Committee on Approval in the two (2) years prior to submitting an application for approval as a continuing nursing education provider.
If you wish to submit an application for a single live or pre-packaged program, please select the "Workshop/Independent Study Applications " link on the left for more information.
Application
CNE Provider - Policies and Procedures
Appendices
Form 5 - Provider Unit Application
Form 6 - Planning Documentation Form (Rev 2 05/11/10)
Form 2 - Biographical Data (Rev 2 05/07/10)
Form 3 - Activity Outline Workshop (Excel format)
Form 3 - Activity Outline Workshop (Word format)
Form 4 - Activity Outline for Ind. Study Pgm (Excel format) (Rev 1 02/26/10)
Form 4 - Activity Outline for Ind. Study Pgm (Word format)(Rev 0 02/26/10)
Form 7 - Report of CNE Activities (Rev 0 (Excel format) 05/17/10)
Form 8 - Quality Improvement Template
Samples/Templates
Form 2 - Sample Biographical Data
Form 3 - Sample Activity Workshop Outline (Rev 0 06/04/10 MS Word)
Commercial Support Agreement Template (Rev 0 05/05/10 MS Word)
Sponsor Agreement Template (Rev 0 05/05/10 MS Word)
Terms and Conditions for Speakers/Authors Template (Rev 0 05/05/10 MS Word)
Provider Application Extension Request
A current provider can request a one-time application extension request in cases of extenuating circumstances. Click here for instructions. |
