Any individual licensed or certified in accordance with this chapter must report any of the following occurrences to the board, within thirty days of the date of the occurrence:
(1) Conviction or discipline for unprofessional conduct or dishonorable conduct, as defined in § 36-4-30;
(2) Any encumbrance of the individual's National Registry of Emergency Medical Technicians or other health care certification or licensure;
(3) Hospital disciplinary action implicating the individual;
(4) Action affecting the individual's privilege to practice;
(5) Judgment or settlement related to the individual's alleged malpractice; and
(6) Change in the individual's:
(a) Home address;
(b) Business address;
(c) Home phone number;
(d) Work phone number;
(e) Email address; or
(f) Other information that is used for communicating with the board.
Failure to report may constitute a basis for disciplinary action against the individual.