N.C. Department of Health and Human Services
Division of Health Service Regulation
Health Care Personnel Education and Credentialing Section
Nurse Aide I Employment Verification by a Registered Nurse
Overview
Welcome! This form is designed to renew a NURSE AIDE I registration only. This form DOES NOT renew a medication aide registration for employment in a long-term care facility.
There is no fee required to complete the online renewal form.
A registered nurse (RN) is required to verify employment for a nurse aide to be renewed in the NC Nurse Aide I Registry. The RN may be either a direct supervisor or another RN who has access to their employment records.
The RN attests that the nurse aide meets the eligibility requirements for renewal below. The RN does not attest to the competency of the nurse aide.
Performed at least eight (8) hours of nursing or nursing related services for pay within their current registration/listing period.
The nursing or nursing related services performed by the nurse aide were supervised by a Registered Nurse (RN).
The nurse aide does not have a finding on the NC Health Care Personnel Registry associated with 42 CFR 483.12.
The FIRST and LAST NAME entered must match what is listed in the
NC Nurse Aide I Registry,
including hyphens and suffixes. Please do not include apostrophe’s when entering the FIRST and LAST NAME. If the name is incorrect, please contact the nurse aide so that they can correct the information in the NC Nurse Aide I Registry.
The nurse aide I registry listing will be updated within 3-5 business days after the employment verification form has been submitted.
Contact the Registry Office if you have any questions about completing the renewal form.
* Denotes required fields
Registry Search
First Name:
*
Last Name:
*
Last 4 Digits of Social Security Number:
*
Date of Birth:
*
Nurse Aide I Listing Number (6 digits):
*
Click The Submit Button to Proceed.
Message:
Registration/Listing Period:
Registration Expiration Date:
DHSR Nurse Aid Registry Website
v 1.38, 09/13/21