Get Writable-initial Application Packet.06.08.2012 - Arizona State Board ...

Filling out the Writable-Initial Application Packet is a crucial step for those seeking to establish a nursing assistant training program in Arizona. This guide offers clear instructions to help users complete each section of the packet accurately and effectively.

Follow the steps to complete your application form successfully.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by providing the program information. This includes the name of the training program and whether it is a consolidated program. Be sure to list any program sites or locations.
3. Input the type of program by selecting the appropriate checkbox, such as Nursing Facility, Hospital, High School, or other options provided.
4. Complete the licensure section by indicating whether the facility is licensed and provide details of the licensing agency and the date of the last review.
5. Fill in the program personnel section. This involves entering the names and contact information of the administrator and program coordinator, along with their qualifications.
6. Document information about the program instructors, ensuring to check their RN license numbers, teaching experience, and qualifications as required.
7. Include details about clinical agencies if applicable. Ensure copies of agreements between your program and cooperative agencies are attached.
8. Compile all required documentation as specified in the form, including a program description, curriculum samples, certification details, and any additional required documents.
9. Once the form is fully completed, review all entries for accuracy before saving the document.
10. Finally, save your changes, and you may choose to download, print, or share the form as necessary.

Start filling out your application online today to ensure compliance and streamline your approval process.