Get Application For Approval As A Nursing Assistant Training Agency - Health Mo

Filling out the Application For Approval As A Nursing Assistant Training Agency is an essential step for those looking to establish a training program. This guide will walk you through each section of the application in a straightforward manner to ensure you complete it accurately.

Follow the steps to complete your application with ease.

1. Click ‘Get Form’ button to access the application and open it in your preferred editing tool.
2. Indicate whether this is a new application, renewal application, or revised application by selecting the appropriate option at the top of the form.
3. Fill in the facility or school name clearly in the designated field.
4. Provide your training agency number, if applicable.
5. List any previous facility or school names as requested in the form.
6. Input the full physical address, including street, city, state, and ZIP code.
7. Enter your telephone number and mailing address in the appropriate sections.
8. Fill out the fax number if you have one available.
9. Print the names of the administrator or director, instructor, and examiner along with their respective license numbers.
10. Indicate the operator name and address as required.
11. Check the boxes that apply to your facility type from the options listed, such as DHSS licensed or non-facility based institutions.
12. Specify what portions of the course will take place at the address provided, in terms of hours, clinical training, and final exams.
13. Mention any portions of the course that will not be conducted at the above address and explain where these will occur.
14. If applicable, ensure you have a signed agreement with any other party where training will occur, and list those training agencies.
15. Provide the names and license numbers of all clinical supervisors.
16. Include the administrator's signature at the end of the application.
17. Review all entered information for accuracy before submitting the application. You can save changes, download, print, or share the form as needed.

Complete your documents online today to ensure compliance and streamline the approval process!