Washington State Nurse Licensure Compact (NLC) Employer Compliance Form

Welcome to the Nurse Licensure Compact (NLC) Employer Compliance Form

With this form, employers can:

Verify and report out-of-state MSL nurses to WABON
Attest to nurses' completion of Suicide Prevention Training
Provide contact information for nurses to receive the link to the demographic survey from WABON

In accordance with Substitute Senate Bill (SSB) 5499 Multistate Nurse Licensure Compact, certain employers and establishments who wish to hire/or have hired a nurse with a multistate license (MSL) issued from a state other than Washington, must attest to the following:

1. The nurse has submitted their required demographic data information via the Washington State Multistate Nurse Demographic Data Survey.

Individuals that hold a multistate nurse license issued by a state other than Washington and are employed by certain establishments shall complete any demographic data surveys required by the board of nursing in rule as a condition of employment.

2. The nurse has completed the required 6-hour Suicide Prevention Training.

Individuals that hold a multistate nurse license issued by a state other than Washington and are employed by certain establishments shall complete the suicide assessment, treatment, and management training required by RCW 43.70.442(5)(a) as a condition of employment.

3. I, the employer or establishment, am reporting employed nurse(s) that hold a multistate license issued by a state other than Washington and am attesting to the required tasks via this form within 30 days of the nurse(s) hire date.

Certain establishments shall report to the board of nursing, within 30 days of employment, all nurses holding a multistate license issued by a state other than Washington and an attestation that the employees holding a multistate license issued by a state other than Washington have completed the tasks required as a condition of employment.