Get Reciprocity Application Package - California Department Of Public ... - Cdph Ca

This guide provides clear and concise instructions for users looking to complete the Reciprocity Application Package for Certified Nurse Assistants and Home Health Aides online. Following these steps will ensure a smooth application process.

Follow the steps to fill out the Reciprocity Application Package online.

1. Click ‘Get Form’ button to obtain the Reciprocity Application Package and open it in the editor.
2. Begin by completing Section I, where you must indicate the type of request you are making. Choose the appropriate box based on whether you are enrolling in a CNA or HHA training program, have equivalent training, or are requesting reciprocity from another state.
3. In Section II, fill out your personal information including your last name, first name, middle initial, mailing address, date of birth, and Social Security Number. Ensure that all fields marked with an asterisk are filled in accurately to avoid delays in processing.
4. Proceed to Section III, where you must answer any questions regarding prior convictions and health-related licensing issues. Ensure to answer truthfully and provide all necessary details.
5. If applicable, fill out Section IV with details about the school or facility where you received your CNA or HHA training, including the start and end dates of your training.
6. In Section V, certify that the information provided is true by signing and dating the application. This step is crucial as it holds legal weight.
7. Finally, review the entire form for accuracy. Save any changes made. Users can then download, print, or share the form as needed.

Complete your documents online to ensure a smooth certification process.