Hera Health Institute

1703 W Colonial Dr, Orlando, FL 32804

Remedial Application Form

General Information

Emergency Contact

Student Demographic data

Academic History


Applicants who have failed the NCLEX three consecutive times must obtain a letter requiring remediation from the FL Board of Nursing. To obtain a letter, please email MQA.NursingAppStatus@flhealth.gov. Applicants will be notified by the Licensure Unit of this requirement.

Employment


(1st, 2nd, 3rd etc.)

Additional Information


Please submit a photo of SSN card

Please submit a photo of your ID
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By submitting this form, I provide my express consent for Center for Professional Training & Development to contact me at the number(s) provided to receive information about Center for Professional Training & Development offerings using a variety of methods, including phone (both mobile or home, dialed manually or automatically), email, mail, social media and text message until Center for Professional Training & Development is notified otherwise. I am not required to provide consent in order to attend Center for Professional Training & Development