N.C. Nurse Aide I and Medication Aide Renewal Application
This file provides essential instructions for renewing Nurse Aide I and Medication Aide listings in North Carolina. It outlines the renewal process, eligibility requirements, and necessary documentation. Ensure compliance with the N.C. Department of Health and Human Services for successful renewal.
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How do I fill this out?
To fill out the renewal application, ensure you have your details ready and accurately report your qualifying work. Follow the instructions carefully and verify all information before submitting. Pay special attention to the signature and supervisor’s verification sections.
How to fill out the N.C. Nurse Aide I and Medication Aide Renewal Application?
1
Verify your name and address are correct on the form.
2
Provide your gender and last four digits of your SSN.
3
Fill in your home and work phone numbers accurately.
4
Complete any address correction if necessary.
5
Ensure your supervisor fills out the second page accurately.
Who needs the N.C. Nurse Aide I and Medication Aide Renewal Application?
1
N.C. Nurse Aides needing to renew their listing.
2
N.C. Medication Aides looking to maintain their certification.
3
Nursing facilities hiring nurse aides requiring updated listings.
4
Health care personnel involved in the training of nurse aides.
5
Supervisors verifying the employment of nurse aides for renewals.
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What are the instructions for submitting this form?
To submit this form, return the completed original document by mail to the Center for Aide Regulation and Education at 2709 Mail Service Center, Raleigh, NC 27699-2709. Ensure that the form is complete, including all necessary signatures. For assistance, call 919-855-3969 during weekdays from 8 a.m. - 12 noon and 1 p.m. - 3 p.m.
What are the important dates for this form in 2024 and 2025?
In 2024, important dates include the application notification to eligible nurse aides three months prior to their renewal deadlines. For 2025, similar timelines will apply, and it is crucial to keep track of your two-year listing period. Make sure to renew on time to avoid additional retraining or testing.
What is the purpose of this form?
The purpose of this form is to facilitate the renewal process for Nurse Aide I and Medication Aide listings in North Carolina. It assists aides in documenting their qualified work experience within the required two-year period. Proper submission of this form ensures continued compliance with state regulations.
Tell me about this form and its components and fields line-by-line.
- 1. Name and Address: Verify that the pre-printed name and address are accurate.
- 2. Gender: Optional field for gender data collection.
- 3. SSN last 4 digits: Required field to identify registry record.
- 4. Home and Work Phone Numbers: For contact purposes.
- 5. Address Correction: For reporting address changes.
What happens if I fail to submit this form?
Failure to submit this form may result in the expiration of your Nurse Aide or Medication Aide listing. This can lead to the inability to work legally in your capacity as an aide until the issue is resolved. It's crucial to adhere to submission timelines to prevent complications.
- Expired Listing: Without renewal, you cannot legally work as an aide.
- Re-training Requirements: Lapsed renewals may necessitate re-training or re-testing.
- Compliance Issues: Failure to submit can lead to non-compliance with state regulations.
How do I know when to use this form?
- 1. Listing Renewal: To renew an expired or expiring aide listing.
- 2. Documentation of Work: To report qualifying work experience for the last two years.
- 3. Compliance Verification: To ensure adherence to N.C. Department of Health regulations.
Frequently Asked Questions
How do I edit the renewal application?
You can edit the renewal application by opening it on PrintFriendly and using the editing tools available.
Can I sign the PDF digitally?
Yes, you can easily add your digital signature to the PDF using our signing feature.
What happens after I fill out the form?
After completing the form, ensure all information is accurate before submitting it.
Is there a way to check my listing status?
Yes, you can check your listing status on the N.C. Nurse Aide Registry website.
What should I do if I make a mistake?
Simply go back to the relevant section in PrintFriendly and make your edits before saving.
How do I get the original form?
You can order the original scannable form from the N.C. Health Care Personnel Registry.
When is the deadline for submission?
You must submit the renewal application three months before your listing expires.
Is there a fee for renewing my listing?
There are currently no fees for the renewal of Nurse Aide I or Medication Aide listings.
Can I submit the form online?
The renewal application must be mailed, as faxes are not accepted.
What if I do not receive the renewal application?
If you do not receive the application, contact the N.C. Health Care Personnel Registry for assistance.
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