Get Professional Certification Branch - Cdph - Ca.gov

This guide provides clear instructions on completing the Professional Certification Branch form for the California Department of Public Health online. It will assist users in navigating the various sections and fields required for certification.

Follow the steps to successfully complete your form

1. Click ‘Get Form’ button to access the certification form and open it in your preferred editor.
2. Begin by entering your full name as it appears on your identification. Ensure accuracy for verification purposes.
3. Input your Social Security Number in the designated field. This information is mandatory for processing your application.
4. Provide your certificate number. If you are a new applicant, you may leave this field blank.
5. For training programs, select all applicable types (Skilled Nursing, Intermediate Care, Hospice, Home Health Agency) and complete the relevant columns A, B, C, D, and E to indicate the training title, provider details, date, and the hours completed.
6. Sign under the certification statement affirming that the information you provided is accurate. This can be done electronically.
7. Review the entire form for completeness and correctness to avoid delays in processing.
8. Once you have finalized your entries, save your changes and proceed with the options to download, print, or share the completed form as necessary.

Complete your certification document online with confidence today.