N.C. Department of Health and Human Services
Division of Health Service Regulation
Health Care Personnel Education and Credentialing Section

 

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Forms and Applications

• Nurse Aide Renewal:
• Online Renewal Form (To be completed by the Nurse Aide)
• Online Employment Verification Form (To be completed by the Registered Nurse)
• Medication Aide Renewal:
• Online Renewal Form (To be completed by the Medication Aide)
• Online Employment Verification Form (To be completed by the Registered Nurse)
• Licensed Nurse Form  (Updated April 2026)
• Reciprocity Application (Updated June 2026)
• Reciprocity Application Frequently Asked Questions
• Registry Change Request Form  (Updated May 2026)

Guidelines:

• How to Submit Forms and Applications
• How to Submit Identifications
• Status Updates

Important Notices:

• Do not use a smart phone to complete or submit the forms.
• Do not enter commas (,) in text fields.
• Submit forms either in PDF or Word format.
• Allow up to 5 business days for the information to be reflected on the registry website.

• Get Adobe Acrobat
• Email the Webmaster
• Disclaimer

• June 9, 2026
• N.C. Division of Health Service Regulation