Nursing Specialization Renewal Form

* Please fill all required fields

To fill the frorm and send it by Email, Click here ( file size 32.19 KB , file type Word document).


Nursing Specialization Renewal Form

Application Date* Mandatory field
Personal information
Full name in English* Mandatory field
Full name in Arabic* Mandatory field
Gender* Mandatory field
Name of Institution work / Department* Mandatory field
Job Title* Mandatory field
Mobile No* Mandatory field
E-mail Address* Mandatory field
Work phone* Mandatory field
Educational level: post-BCs * Mandatory field
Specialization level* Mandatory field
University name of specialization level earned* Mandatory field
Last Specialization Certificate Issue Date* Mandatory field
Specialization Certificate Validation Date* Mandatory field
Serial No of the specialization certificate* Mandatory field
Continuing Education Hours
- For Nurse Specialist /midwifery Specialist: provide (36) continuing education hours, 60% of the hours in specialty area and 40% in other health fields.javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$MainContent$btnAddFields", "", true, "FieldsGroup", "", false, true))
- For Advanced Nurse Specialist/Advanced midwifery Specialist: provide (50) Continuing education hours, 60% of the hours in specialty area and 40% in other health fields.
Please fill below: Activity Title, Activity Date, Institution, and Contact hours ( Specialty 60%, General 40%)* Mandatory field
Clinical Hours
Provide at least 250 practice days in specialization field during the three years of renewal for Nurse Specialist /midwifery Specialist & Advanced Nurse Specialist/Advanced midwifery Specialist).
Please fill below: Description of working activity (Regular work, Part time, Independent work, Supervising of nursing students), Name of institution, unit, Date and Number of days)* Mandatory field
Additional requirements for Advanced Nurse Specialist/Advanced midwifery Specialist)
Please Fill below: Name of the requirements (Participation in nursing project based on Evidence Based, Hold a Lecture in specialization field and be the main speaker for five hours continuing education at least,Publish a research or an article in nursing), Title, Institution, Contact hours and Date* Mandatory field

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