Get Applicants , Please Complete All Information Below ... - Ndhealth

Completing the APPLICANTS form for the North Dakota Home Health Aide application can seem daunting, but with clear guidance, you can navigate it efficiently. This guide provides step-by-step instructions to help you fill out the form accurately and completely.

Follow the steps to fill out the form correctly:

1. Click ‘Get Form’ button to obtain the application form and open it in an appropriate online editor.
2. Begin filling in your personal information. This includes your first name, last name, maiden or middle initial, current mailing address (ensure to include any c/o address if applicable), city, state, zip code, and county of residence.
3. Provide your contact details by including your home phone number, work phone number, cell phone number, and email address.
4. Fill in your date of birth accurately, along with your Social Security number, which is a required field.
5. Enter your current employment details by providing the name of your employer, their location including city and state, and the contact name and phone number of someone at your workplace.
6. If applicable, provide your registrant ID number and the current expiration date of your certification.
7. Complete the list of questions regarding your background and qualifications. Ensure you respond to every question regarding arrests, sanctions, or disciplinary actions within the last two years.
8. If your answers include 'yes' to any of the questions about past incidents, prepare to attach a detailed written explanation and any relevant legal documents to your application.
9. Sign the application in the designated section to certify that the information you provided is true and complete, and note the date of your signature.
10. If you have completed a Home Health Aide training program, please provide the name of the program, address, and dates of enrollment and completion.
11. For verification of your competency as a Home Health Aide, ensure a licensed or registered nurse signs the corresponding section, providing their information as well.
12. Finally, indicate your employment status and sign off with your employer's information if applicable. After completing the form, you can save your changes, download, print, or share the form as needed.

Start completing your application online now!