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. * 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 Aide Registry Website
v 1.39, 11/03/2023