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Get Wa Dshs 16-193 2016-2026
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How to fill out the WA DSHS 16-193 online
The WA DSHS 16-193 form is an essential document for nursing assistants seeking registration in Washington. This guide provides clear, step-by-step instructions to help users navigate the online process and ensure that all necessary information is correctly submitted.
Follow the steps to fill out the WA DSHS 16-193 form online
- Press the ‘Get Form’ button to access the form and open it in the editor.
- Begin by filling in the facility name at the top of the form. This information is crucial for identification.
- Next, complete the contact person field. Provide the name of the individual responsible for submitting the inquiry.
- Fill in the telephone number for the contact person to ensure easy communication regarding the inquiry.
- Enter a return email address where the completed inquiry can be sent.
- Provide the complete address, including the city, state, and ZIP code, where the facility is located.
- In the employee’s name section, enter the last name, first name, and middle initial as applicable.
- Input the employee's date of birth in the format MM/DD/YY.
- Fill in the employee's social security number. Ensure it is accurate as this information is sensitive.
- Enter the NAC or NAR credential number if applicable; this helps in verifying the credentials.
- Complete the previous employment section for up to ten entries. Use the format MM/DD/YY for both the first date employed and last date employed as an NA.
- Ensure that all columns are complete and review for accuracy before submission.
- Once all fields are filled out, save your changes, and prepare to submit the form electronically.
- Email the completed inquiry form to obraregistry@dshs.wa.gov as stated in the instructions.
Complete the WA DSHS 16-193 form online to ensure your registration is processed efficiently.
Reporting changes to DSHS in Washington State is straightforward. You can report changes online through your DSHS account, or you can call their customer service for assistance. It's essential to keep your information up to date to avoid any interruptions in your benefits. Remember to mention WA DSHS 16-193 whenever you are discussing your case.
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