6) 327-2445 FAX: (916) 324-0901 State of California- Health and Human Services Agency SCHOOL NURSE ASSISTANT CERTIFICATION TRAINING PROGRAM APPLICATION TYPE OR PRINT LEGIBLY. SEE REVERSE FOR INSTRUCTIONS. For CDPH Use Only School Name and Address: School Training Site Address (if different): Provider Identification Training Number: Phone: County:.
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How to fill out the Cdph 276s online
The Cdph 276s is a crucial document for those applying for school nurse assistant certification training programs in California. This guide provides a clear and comprehensive approach to filling out the form online, ensuring all necessary information is accurately submitted.
Follow the steps to complete the Cdph 276s form online.
- Click ‘Get Form’ button to obtain the Cdph 276s form and open it in your preferred editing tool.
- Begin by entering the school name and address in the designated fields, ensuring that all information is accurate and complete.
- If the training site address differs from the school address, provide it in the specified area. Include the provider identification training number and the contact phone number.
- Fill in the county name where the training will be conducted in the appropriate section.
- List the registered nurse who is responsible for the program, including their printed name and signature. This individual certifies the completion of the 150-hour nurse aide training program.
- Discuss the training schedule. Check or circle the appropriate options for training days and indicate whether the hours will occur in the morning, afternoon, or on weekends.
- Detail the total clinical hours required and describe the curriculum used for the training program.
- Sign and date the application at the bottom, certifying that the information provided is accurate and complete.
- As a final step, review the filled form for accuracy, save any changes, and then download or print the completed document as necessary.
Get started on your application by filling out the Cdph 276s form online today!
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