Get Cdph 283c

Filling out the Cdph 283c form online can streamline the renewal process for certified nurse assistants and home health aides. This guide provides clear, step-by-step instructions to help users navigate each section of the form with ease.

Follow the steps to fill out your Cdph 283c form online:

1. Click the ‘Get Form’ button to access the Cdph 283c form in an online editor.
2. Complete Section I by selecting your type of request: CNA Renewal, HHA Renewal, or CNA Reactivation. Enter your certificate number where prompted.
3. Fill out Section II with your personal information, including your last name, first name, middle initial, sex, mailing address, date of birth, and Social Security Number. Be sure to provide valid information as inaccuracies can delay processing.
4. In Section III, answer the questions regarding any criminal convictions or adverse actions taken against you by health-related licensing authorities since your last renewal. If applicable, provide details and dates.
5. If you are applying as an HHA, complete Section IV to confirm that you have completed the required 24 hours of in-service training or continuing education units during your certification period.
6. For CNA applicants, fill out Section V by providing documentation of your in-service training, ensuring that you meet the required 48 hours within your certification period.
7. In Section VI, if you are reactivating your CNA, indicate whether you have met the renewal requirements. If not, check the relevant box to apply for reactivation through the Competency Evaluation.
8. Complete Section VII by certifying that the information provided is true and sign the form. Include the date of signature.
9. Once you have reviewed all entered information for accuracy, you can save changes, download the form, print it, or share it as necessary.

Start filling out your Cdph 283c form online today to ensure a smooth renewal process.