Nova Scotia College of Medical Laboratory Technologists

Letter of Standing Request Form

REQUEST AND CONSENT FOR LETTER OF STANDING

In completing the Letter of Standing Request form you are giving NSCMLT permission to share your information related to your registration as a Medical Laboratory Technologist and disclosed pursuant to this Request and Consent.

You understand and agree that the information disclosed in the Letter of Standing may contain personal information about you as defined in the Personal Information Protection and Electronic Documents Act, S.C. 2000, c. 5 (PIPEDA).

You understand and agree that in addition to personal information about you, the information disclosed in the Letter of Standing may contain the following:

Information that will be Disclosed in the Letter of Standing include: 

  • Information related to your registration, including full name and registration number, status, year of first registration, year of expiry, date of resignation, etc;
  • Specialization, if any;
  • Your qualifications and credentials;
  • Your self-reported MLT practice hours for the last five years, if collected;
  • Any fees currently owed by you to the regulator;
  • Whether you are in compliance with the regulator's professional liability insurance requirements;
  • Your registration history with other regulators, if known;
  • The details of  any current or past restrictions, terms, limitations, conditions, or interim orders on my certificate/license;
  • The details of, and reasons for, any current or past suspensions or revocations, (including for non-payment of fees);
  • Whether you are in compliance with any continuing competence, professional development or quality assurance program (or similar program);
  • Details of any current or past acknowledgements and undertakings you have entered into'
  • Whether you are currently being investigated by any regulatory body;
  • The details of any current complaints/reports/inquiries, investigations, or proceedings alleging professional misconduct, incompetence or incapacity against me;
  • The details of any past disciplinary or fitness to practice findings made against you. including penalities ordered;
  • The details of any existing charges against you and any restrictions (such as bail conditions) in relation to any offence;
  • The details of any findings of guilty against you in relation to any offence; and 
  • Any other information about your conduct, competence, or capacity that in the opinion of the Registrar is relevant to your suitability to be registered as a Medical Laboratory Technologist. 

***By completing the electronic form and payment you are consenting to the disclosing of such information and declare that you have read the above  "Information that will be Disclosed in the Letter of Standing include" . You acknowledge that  the College has advised you that you have the right to obtain legal advice prior to executing this consent, and that you have either done so or have had sufficient opportunity to do so prior to executing this Request and Consent for Letter of Standing. You are submitting this form on your own free will, voluntarily and without coercion, having read and understood it. 

To request a Letter of Standing:

 After you submit the letter of standing request form and payment, we will issue to the regulatory body of your choice a letter confirming your current or former registration and licensure with NSCMLT . This letter is sent directly to the other regulatory body only and a copy will be found when you sign into the NSCMLT website under documents. If you would like the letter to be sent to multiple regulatory bodies please select all that apply in the form. We will complete this request within 15 business days once we receive both the form and payment. 

 

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Land Acknowledgement - NSCMLT would like to begin by respectfully acknowleding that the province of Nova Scotia is the ancestral homelands of many diverse populations and acknowledge that we are on the traditional lands, referred to as Mi'kma'ki the ancestral and unceded territory of the Mi'kmaq People who are the founding people of Nova Scotia under the "Treaties of Peace and Friendship". We respect the Peace and Friendship treaties, we acknowledge the harms and mistakes of the past, and we dedicate ourselves to move forward in partnership with Indigenous communities in a spirit of reconciliation and collaboration.  

Get in Touch

380 Bedford Highway, Suite 202
Halifax, Nova Scotia B3M 2L4

Phone 902-789-6465

Email info@nscmlt.org

 

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