Get Recertification Application Odh Form 717 - State Of Oklahoma ... - Ok

This guide provides clear and concise instructions for completing the Recertification Application ODH Form 717 in Oklahoma. Whether you are a certified nurse aide or a healthcare professional renewing your certification, following these steps will help ensure your form is filled out correctly and submitted on time.

Follow the steps to complete your recertification application efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your personal information. Fill in your date of birth, legal name (first, middle initial, last), and social security number. This information is crucial for your identification.
3. Provide your current mailing address, including the city, state, and zip code, along with your telephone number. It is essential for the registry to contact you regarding your application.
4. Next, navigate to the employment information section. Enter the start and end dates of your relevant work experience, along with the facility name and address. Indicate if you are still employed there by selecting 'Yes' or 'No.'
5. Include the signature of an administrator, director, or human resource staff from your workplace to validate your employment. Ensure you also attach a copy of your paystub or W-2 form as proof of employment.
6. In the certification renewal section, check the type of nurse aide certification you wish to renew. This could include renewing licensed nurse aide, residential care aide, or several other categories with accompanying fees.
7. If you are renewing your certified medication aide certification, indicate your attendance at an eight-hour continuing education course and provide the name and date of the class.
8. Review your application thoroughly to ensure all information is complete and accurate. Any discrepancies may delay processing time.
9. Choose your payment method for any applicable fees, making checks payable to the Oklahoma State Department of Health. Be aware that all fees are non-refundable.
10. Once you have completed the form, save your changes and print a copy for your records. You may also need to download the form and share it with relevant parties if required.

Complete your recertification application online today to ensure your credentials remain valid.