Get Ne Nurse Aide Termination Form 2014-2025

Completing the NE Nurse Aide Termination Form online is an essential process for notifying the Nebraska Nurse Aide Registry of a termination. This guide provides clear instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the termination form online.

1. Use the ‘Get Form’ button to access and open the NE Nurse Aide Termination Form in your preferred editor.
2. In the 'Facility' field, enter the name of the facility where the individual was employed. Be precise and ensure correct spelling to avoid any processing issues.
3. Fill in the 'City,' 'State,' and 'ZIP' code fields with the relevant location details of the facility.
4. Input the 'Social Security Number or Registry Number' of the individual. This information is crucial for identification purposes.
5. In the 'Individual's Name' section, provide the last name, first name, and middle name of the individual. Make sure the names are accurate as they will appear in official records.
6. Record the 'Date of Hire,' entering the month, day, and year when the individual started their position.
7. Fill in the 'Date Terminated' with the month, day, and year the individual's employment ended. This date is important for the records.
8. After completing all necessary fields, review the information for accuracy. Make any corrections required.
9. Once satisfied with the entries, save your changes. You can download, print, or share the completed form as needed.
10. To submit the form, ensure you send it to the Nebraska Nurse Aide Registry at the provided address, fax number, or email.

Take the next step to complete and submit the NE Nurse Aide Termination Form online today.