Reinstatement and Dialysis Technician Contact Form

Use this form to request information about:

  • Dialysis Training Credential
  • Licensure by Reinstatement
  • Retiring a license
  • Sexual Assault Nurse Examiner (SANE) credentialing

NOTE: Contact pages are unsecured web pages intended for the transmission of general queries and information. If your question requires the transmission of sensitive data, such as social security number or date of birth, please call 1-800-305-2042 or 502-403-8084​ to be connected with a staff member directly. This notice does not cover license numbers, which are already in the public domain, or KBN applications, which use the highest level of security commercially available.


Example: 502-875-3733