Get Nurses Aide Program

Completing the Nurses Aide Program is essential for maintaining your eligibility to work in federally certified facilities. This guide will provide clear and supportive instructions to help you fill out the Nurses Aide Registry Renewal Form accurately and efficiently.

Follow the steps to successfully complete the Nurses Aide Program application.

1. Press the ‘Get Form’ button to access the form and open it in the online editor.
2. Begin by entering your Social Security number or your previously assigned Nurse Aide Registry identification number. Remember, providing your Social Security number is voluntary.
3. Select your gender by checking the appropriate box, either female or male.
4. Input your date of birth, specifying the month, date, and year.
5. If your name has changed, check ‘yes’ and enter your current legal name, ensuring you do not use any nicknames.
6. If applicable, provide your previous name in case of changes in your last name, first name, or middle initial.
7. Enter your current mailing address, including street, P.O. box, city, state, and ZIP code.
8. Include both your home and work telephone numbers in the designated fields.
9. Sign the form and date it in the given section. Your signature is mandatory to validate the information provided.
10. If you are filling out Section II, the healthcare employer must enter the individual's start date of employment and verify if the nurse aide has provided services for at least eight hours for pay in the last twenty-four months.
11. The healthcare employer should fill in the name and address of their facility and confirm whether the nurse aide is a direct employee or a contracted pool aide.
12. Finally, the healthcare facility representative must sign and date the form, verifying the supervision of the nurse aide’s nursing-related duties.
13. Once completed, mail the renewal form to Pearson VUE – Wisconsin Nurse Aide Registry. Ensure that your form is complete, signed, and legible to avoid processing delays.

Fill out your Nurses Aide Program application online today to maintain your certification and employment eligibility.