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Get Ca Cdph 283 B 2015
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How to fill out the CA CDPH 283 B online
The CA CDPH 283 B form is essential for individuals seeking to apply for certification as a certified nurse assistant or home health aide in California. Completing this application accurately is crucial for a smooth processing experience.
Follow the steps to successfully complete the online form.
- Click ‘Get Form’ button to access the CA CDPH 283 B application and open it for editing.
- In Section I, select the type of request by checking the appropriate box for either enrolling in CNA training, HHA training, equivalent training, or requesting reciprocity from another state. Ensure to provide the state if requesting reciprocity.
- Proceed to Section II. Fill in your last name, first name, middle initial, sex, mailing address, city, state, zip code, date of birth, social security number (note that an invalid SSN may delay processing), driver’s license or state ID number, and your telephone number.
- In Section III, answer the required questions regarding any criminal convictions and any health-related licensing actions against you. Provide details if applicable.
- For Section IV, provide the name and mailing address of the school or facility where you plan to receive your CNA or HHA training. Include the California Training Program ID number and the beginning and end dates of your training.
- In Section V, certify the information provided is true and correct by signing and dating the application.
- Once all necessary sections are completed, save the changes made to your application. You may also choose to download, print, or share the completed form as needed.
Complete your CA CDPH 283 B application online to start your journey in healthcare today!
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The CA CDPH 283 B form is a critical document used for applying for CNA reciprocity in California. This form collects essential information about your out-of-state certification and your qualifications as a nursing assistant. Proper completion of the CA CDPH 283 B form is necessary to facilitate the approval process and ensure your ability to work in California’s healthcare system.
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