Home health aide registry application

    • [PDF File](1) Application for Home Care Aide Registration (HCS 100)

      https://info.5y1.org/home-health-aide-registry-application_1_0f97c5.html

      (a) Any individual seeking to obtain Home Care Aide registration shall file with the Department an application by one of the following means: (1) A Home Care Aide Registry application mailed to the Department with non-refundable application fee, as specified in subdivision (a) of section 130084, paid by check or money order.

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    • [PDF File]APPLICATION FOR HOME CARE AIDE REGISTRATION

      https://info.5y1.org/home-health-aide-registry-application_1_ed598e.html

      Per Health and Safety Code Section 1796.48, the Home Care Aide application fee is nonrefundable. If any of the following apply, then you are not eligible for Home Care Aide registration at . this time. Please note, if you continue with the application process, your application will be withdrawn and your fee will be forfeited.

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    • [PDF File]APPLICATION FOR HOME CARE AIDE REGISTRATION

      https://info.5y1.org/home-health-aide-registry-application_1_b33a93.html

      Per Health and Safety Code Section 1796.48, the Home Care Aide Renewal application fee is nonrefundable. If any of the following apply, then you are not eligible to renew your Home Care Aide registration at this time. Please note, if you continue with the renewal process, your renewal application will be withdrawn and your fee will be forfeited.

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    • [PDF File]APPLICATION FOR HOME CARE AIDE REGISTRATION For …

      https://info.5y1.org/home-health-aide-registry-application_1_8d98c9.html

      application for home care aide registration instructions To become listed on the Home Care Aide Registry, you must complete and mail the attached application (HCS 100) and the Criminal Record Statement (LIC 508) and a check or money order to the address listed on the top of the application form.

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    • [PDF File]HOME HEALTH AIDE RENEWAL APPLICATION North Dakota ...

      https://info.5y1.org/home-health-aide-registry-application_1_9b74a4.html

      Home Health Aide Nurse Competency Verification . A licensed or registered nurse must verify the Home Health Aide’s (applicant) competency (within the last year) to provide Home Health Aide services. This Home Health Aide has completed the necessary competency verification within the past year, as indicated by NDAC 33-43-01-05.

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    • HOME HEALTH AIDE REGISTRY APPLICATION - Indiana

      HOME HEALTH AIDE REGISTRY APPLICATION State Form 49560 (R8 / 4-20) INDIANA STATE DEPARTMENT OF HEALTH-DIVISION OF ACUTE CARE *Your Social Security number is requested in accordance with the provision of IC 4‐1‐8‐1. Disclosure is mandatory and this record cannot be processed without it.

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