Massachusetts Nurse Aide Reciprocity Application Instructions

To submit the Massachusetts Nurse Aide Reciprocity Application, complete the form and send it to the Nurse Aide Registry of the state where you are currently certified. Once verified, either mail the original completed application to Prometric, MA Nurse Aide, 7941 Corporate Drive, Nottingham, MD 21236, or have your current state registry send it directly. Ensure the completed applications are submitted within 30 days of verification. For any assistance, contact Prometric staff at MACNA@prometric.com or 1-800-722-2594. My advice is to ensure all steps are followed accurately and promptly to avoid delays.

Submit your completed Massachusetts Nurse Aide Reciprocity Application within 30 days of verification from your current state's Nurse Aide Registry.

The Massachusetts Nurse Aide Reciprocity Application is designed for certified nursing assistants (CNAs) who are currently certified in another state and wish to work in Massachusetts. This form helps streamline the process of transferring your certification to the Massachusetts Nurse Aide Registry. By completing this application accurately and timely, you can ensure a smooth transition and continue your practice in Massachusetts.

• 1. Last Name: Your legal last name as it appears on your current certification.
• 2. First Name: Your legal first name as it appears on your current certification.
• 3. Middle Initial: Your middle initial, if applicable.
• 4. Street Address: Your current street address where you reside.
• 5. City: The city you reside in.
• 6. State: The state you reside in.
• 7. Zip Code: Your current zip code.
• 8. Social Security Number: Your social security number.
• 9. Date of Birth: Your date of birth.
• 10. Daytime Phone Number (with Area Code): Your daytime phone number, including the area code.
• 11. Email Address: Your current email address.
• 12. State in which you are currently registered: The name of the state where you are currently certified as a nursing assistant.
• 13. Current Registration Number: Your current certification or registration number.
• 14. Expiration Date: The expiration date of your current certification.
• 15. Candidate Signature: Your signature, certifying the accuracy of the information provided.
• 16. Date: The date you signed the application.
• 17. Verification by Current State Registry: Section to be completed by the state registry where you are currently certified.
• 18. Confirmation of State Registry: Confirms your status, including your standing and any findings of abuse or neglect.
• 19. Verifying Agency/Current State Registry Name: The name of the agency verifying your current certification.
• 20. Title: Title of the authorized registry representative.
• 21. Authorized Signature of Current State Registry: Signature of the authorized registry representative.
• 22. Date: The date the registry representative signed the application.

If you fail to submit the Massachusetts Nurse Aide Reciprocity Application, you will not be able to transfer your certification to Massachusetts. This may result in delays or inability to work as a certified nursing assistant in the state.

• Delay in Certification: Your certification transfer will be delayed, affecting your ability to work.
• Inability to Work in Massachusetts: Failure to submit the form prevents you from being certified in Massachusetts.
• Missed Deadlines: You may miss important deadlines, requiring re-submission and additional verification.

• 1. Transfer Certification: To transfer your current nursing assistant certification to Massachusetts.
• 2. Verify Good Standing: To verify your good standing on the current state's Nurse Aide Registry.
• 3. Confirm Certification: To confirm your certification details with the Massachusetts Nurse Aide Registry.
• 4. Renew Certification: To renew your nursing assistant certification by transferring it to a new state.
• 5. Employment Opportunity: To seek employment as a certified nursing assistant in Massachusetts.