Compliance Monitoring Forms & Probation Information

 

Compliance Monitoring Forms

   Re-entry to Nursing Practice
   Quarterly Substance Use Disorder/Mental Health Continuing Treatment Form
   Contact and Change of Information Form
   Employment Status Report
   Prescription Identification Form
   Sobriety Notebook
   Support Group Attendance Form

Probation Information

   ATI Information
   Substance Use Assessment Evaluator List

Third Party Administrator (TPA) Information

As part of your monitoring program with the Missouri State Board of Nursing (Board) you are required to contract with the Board’s third party administrator (TPA).

You have two companies you may choose from. It is important that you make an informed decision on the testing company that you choose. To discuss the check in, testing, and payment policies, contact the companies directly.

Frequency of testing and the testing panel will not differ. The cost of urine drug testing averages about $55 - $95 per screen. The cost of blood, nail and hair drug testing averages between $130 - $490. Costs will vary based on testing requirements and are the participant's responsibility. All samples, regardless of the company, must be directly observed upon collection. The time frame for checking in to determine if testing is required will not differ, it is defined in your legal document as seven (7) days a week between 5:00 a.m. central standard time and 4:00 p.m. central standard time.

Once you have chosen the TPA and contracted with them, the Board expects you to remain with that company. If you should decide to change TPAs for any reason, there must not be a gap in checking in. Approved third-party administrators are:

Affinity Care (Spectrum)
1-877-267-4304
Affinity Packet
If you have chosen Affinity, please email nursingcompliance@pr.mo.gov.
National Toxicology Specialists
615-353-1888
NTS Packet
If you have chosen NTS, please see NTS instructions.


Compliance Contact

573-751-6541 Telephone
nursingcompliance@pr.mo.gov