Serving Immigrant
Nurses and American
Healthcare Employers

NIS Form for More Information

Fill out this form for more information from NIS to begin your immigration to the U.S.

Nurse Immigration Services will contact you by e-mail to provide you with more information and application materials. There is no risk or obligation.

If you are not a nurse, click here to send us a short message.

Registered Nurse name: (Required)
RN license number:

Country of RN License:

(If you have other licenses, please specify in the comments field.)

E-mail address:



Mailing address (optional)

Address line 1:

Address line 2:

Address line 3:

Check one for each test: (Required) Scheduled  
  Test Passed within
3 months
To sign up with NIS, you must have passed NCLEX:
Select State: for NCLEX licensing
(Indicate the State Board of Nursing from which you are seeking licensure.)

VisaScreen Certificate: (Required) Do Have Do NOT Have

We can begin to process your application after you have 6 months experience.  You will need to have worked for 1 year by the time you come to the US. Please list your recent work experience (Required)

List location:

Since what date:

Check all that apply to your experience:

Emergency Room (ER)
Intensive Care Unit (ICU)
Labor and Delivery (LD)
Med Surg (MS)
Neonatal Intensive Care (NICU)  
Operating Room (OR)
Pediatric (PEDS)
Pediatric Intensive Care (PICU)
Cardiac Care Unit (CCU)
Cath Lab
Recovery Room (PACU)




To Contact Us
Nurse Immigration Services
United States Office
124 Towne Terrace
Santa Cruz, California 95060
Tele:  831-425-5820
Fax:  831-425-1706
E-mail:  contact @
Tele: 0-907-569-6539
  Contact NIS in the Philippines
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