Content Overview
The Texas Nurse Aide Registry 5505-NAR form plays a crucial role in the certification process for nurse aides in Texas. This form is essential for individuals seeking to become certified nurse aides, as it collects important information that verifies their qualifications and background. Applicants are required to provide personal details, including their name, contact information, and social security number. Additionally, the form requires the submission of proof of training, which may include details about the educational institution attended and the completion of required coursework. Background checks are also a significant component, ensuring that candidates meet the necessary standards for working in healthcare settings. By filling out the 5505-NAR form accurately and completely, applicants help facilitate their entry into a rewarding career that supports patients and enhances the healthcare system. Understanding the various sections of this form is vital for prospective nurse aides, as it not only outlines the steps needed for certification but also highlights the importance of compliance with state regulations.
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Form 5505-NAR
December 2022-E
Texas Nurse Aide Registry
Request for Entry on the Texas Nurse Aide Registry Through Reciprocity
Applicant Information (To be completed by applicant.)
Note: You are not eligible to be employed as a nurse aide in the state of Texas until your request has been approved and you have been
entered into the registry.
Read the following instructions before completing this form.
• Complete all information in Section 1. Your signature is required at the bottom of Section 1 to verify that information you provided is correct.
• Once Section 1 is complete, email this form, a legible copy of a government issued identification that shows your birth date and the correct spelling
of your name, copy of your Social Security card, and your Texas criminal history results for all legal last names you ever had from the Texas
Department of Public Safety at publicsite.dps.texas.gov/ConvictionNameSearch to: [email protected]
(See back of form for more
instructions.)
• If you do not have an expiration date in the state you are active in, you must also complete and submit Form 5506-NAR, Employment Verification.
The form must be completed by your most recent employer (within the last two years).
Name (Last, First, Middle): Maiden Name (if applicable):
Social Security No.:
Sex:
Male Female
Date of Birth: Email Address:
Mailing Address (Street or P.O. Box):
City: State: ZIP Code: Phone No.:
State(s) Where Issued: Nurse Aide Certificate No.(s) Issue Date(s):
Signature – Applicant
Date
You must submit the following items:
Completed Form 5505-NAR – Signed and dated
Copy of your government issued current photo ID
Copy of your Social Security card
Texas Department of Public Safety criminal history check for all legal last names ever had (either Fingerprint Cards with results or Name
Based completed online for all last names ever used)
Email the completed form and required documents to the Texas Nurse Aide Registry at [email protected]
.
Form 5505-NAR
Page 2 / 12-2022-E
Address:
Instructions
Nurse Aides who are listed active on a registry in another state and are requesting to be placed on the Texas Nurse Aide Registry by
reciprocity must meet eligibility requirements listed, per Texas Standards for Nurse Aides, Section twenty six26 TAC 556.11(b)(1-5). No
person listed as unemployable on the Employee Misconduct Registry (EMR) or who has been found to have a conviction of a criminal offense
listed in Texas Health and Safety Code, Section250.006, will be eligible for reciprocity. Find Chapter 250 and for list of convictions at
statutes.legis.state.tx.us\Docs\HS\htm\HS.250.htm#00.
Nurse Aide Registry staff will complete the EMR check.
The person requesting reciprocity must obtain a criminal history check from the Texas Department of Public Safety (DPS). For instructions on
how a person can obtain a named-based criminal history check for all names ever used, visit publicsite.dps.texas.gov/ConvictionNameSearch.
You must submit your criminal history results along with the reciprocity Form 5505-NAR to be placed on the Texas Nurse Aide Registry by
reciprocity.
Applicant, did you:
• Sign the form?
• Include your criminal history results for all last names you ever had, a legible photocopy of your state issued picture identification showing
your birth date and correct spelling of your name, and a copy of your Social Security card?
Did you know?
• You can verify certificate status by using the following link: emr.dads.state.tx.us/DadsEMRWeb/
• You can download forms from our website:
hhs.texas.gov/doing-business-hhs/licensing-credentialing-regulation/credentialing/nurse-aide-
registry/nar-forms
With a few exceptions, you have the right to request and be informed about the information that the Texas Health and Human Services
Commission (HHSC) obtains about you. You are entitled to receive and review the information upon request. You also have the right to ask
HHSC to correct information that is determined to be incorrect (Government Code, Sections 552.021, 552.023, 559.004). To find out about
your information and your right to request correction, please call the Nurse Aide Registry at 512-438-2050.
Form Specifications
| Fact Name | Description |
|---|---|
| Purpose | The Texas Nurse Aide Registry 5505-NAR form is used to apply for certification as a nurse aide in Texas. |
| Eligibility | Applicants must meet specific training requirements and pass a competency exam to qualify for certification. |
| Governing Law | This form is governed by the Texas Health and Safety Code, Chapter 250, which outlines the regulations for nurse aides. |
| Submission Process | Completed forms must be submitted to the Texas Department of Aging and Disability Services for processing. |
Texas Nurse Aide Registry 5505-NAR: Usage Guidelines
Filling out the Texas Nurse Aide Registry 5505-NAR form is an important step in the process of becoming a certified nurse aide in Texas. After completing this form, it will be submitted to the appropriate regulatory body for review and processing. Ensure that all information is accurate and complete to avoid delays in your application.
- Obtain the Texas Nurse Aide Registry 5505-NAR form. This can be done online or through designated locations.
- Begin by filling out your personal information. This includes your full name, address, phone number, and email address.
- Provide your Social Security number. Ensure that it is entered correctly to avoid processing issues.
- Indicate your date of birth. This information is necessary for identification purposes.
- Complete the section regarding your education and training. List any relevant programs or certifications you have completed.
- Detail your employment history. Include the names of employers, positions held, and dates of employment.
- Answer any questions related to your criminal history. This section is crucial for the background check process.
- Review the form for accuracy. Ensure all sections are filled out completely and correctly.
- Sign and date the form. Your signature confirms that all information provided is true and accurate.
- Submit the completed form according to the instructions provided. Keep a copy for your records.
Your Questions, Answered
What is the Texas Nurse Aide Registry 5505-NAR form?
The Texas Nurse Aide Registry 5505-NAR form is a crucial document used for the registration of nurse aides in Texas. This form serves as an official application for individuals seeking to become certified nurse aides (CNAs) in the state. By completing this form, applicants provide necessary information that helps ensure they meet the state’s requirements for training and competency evaluation.
Who needs to fill out the 5505-NAR form?
Individuals who have completed a nurse aide training program and wish to become certified in Texas must fill out the 5505-NAR form. This includes those who have recently graduated from a training program and are looking to register for the first time, as well as those who may be reapplying after a lapse in certification.
What information is required on the form?
The form requires several key pieces of information. Applicants must provide personal details such as their name, address, date of birth, and Social Security number. Additionally, information about the training program completed, including the program's name and completion date, is necessary. Background information, including any prior convictions, may also be required to ensure compliance with state regulations.
How do I submit the 5505-NAR form?
Once you have completed the 5505-NAR form, it can be submitted via mail to the Texas Nurse Aide Registry. It is important to ensure that the form is signed and dated before submission. Be sure to check the mailing address provided on the form itself, as it may change from time to time. Some applicants may also have the option to submit the form electronically, depending on the latest guidelines from the Texas Health and Human Services Commission.
How long does it take to process the application?
The processing time for the 5505-NAR form can vary. Generally, applicants can expect to receive confirmation of their application status within a few weeks. However, during peak times or if additional information is needed, it may take longer. Applicants are encouraged to check their status online or contact the registry directly if they have concerns about their application timeline.
What should I do if my application is denied?
If your application for certification is denied, you will receive a notification explaining the reasons for the denial. It is essential to carefully review this information. Depending on the situation, you may have the option to appeal the decision. Instructions on how to proceed with an appeal will typically be included in the denial notification. Seeking guidance from a knowledgeable professional can also be beneficial in navigating the appeals process.
Common mistakes
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Incomplete Information: One common mistake is leaving sections of the form blank. Every part of the Texas Nurse Aide Registry 5505-NAR form must be filled out completely. Omitting information can lead to delays in processing your application.
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Incorrect Personal Details: Applicants sometimes enter incorrect personal information, such as misspelled names or wrong dates of birth. Double-checking these details is crucial, as any discrepancies can cause complications.
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Failure to Sign: Forgetting to sign the form is another frequent error. Without a signature, the application cannot be processed. Ensure that you sign and date the form in the designated area before submission.
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Not Including Required Documents: Submitting the form without the necessary supporting documents is a mistake that can halt your application. Make sure to include all required documents, such as proof of training and identification, to avoid delays.
Documents used along the form
The Texas Nurse Aide Registry 5505-NAR form is an essential document for individuals seeking to become certified nurse aides in Texas. Alongside this form, several other documents are often required or helpful in the certification process. Below is a list of these forms and documents, each serving a specific purpose in the application and certification journey.
- Background Check Consent Form: This form authorizes the Texas Department of Health to conduct a criminal background check on the applicant. It is a crucial step to ensure the safety of patients and compliance with state regulations.
- Training Program Completion Certificate: This certificate verifies that the applicant has successfully completed a state-approved nurse aide training program. It is necessary to demonstrate the required education and skills.
- Application for Nurse Aide Certification: This application is submitted to the Texas Nurse Aide Registry and includes personal information, training details, and other relevant data necessary for certification consideration.
- Proof of Identity: Acceptable forms of identification, such as a driver's license or passport, are required to verify the applicant's identity. This helps prevent fraud and ensures accurate record-keeping.
- Social Security Card: A copy of the applicant's Social Security card is often needed to confirm their identity and eligibility to work in the United States.
- Exam Registration Form: This form is used to register for the nurse aide certification exam. It includes details about the preferred testing location and date.
- Continuing Education Documentation: For those renewing their certification, documentation of completed continuing education courses may be required to demonstrate ongoing competency and knowledge in the field.
These documents collectively support the application process for nurse aide certification in Texas. Ensuring that all forms are accurately completed and submitted can help facilitate a smoother certification experience.
Similar forms
- Application for Nurse Aide Certification: This document is used to apply for certification as a nurse aide in Texas. Like the 5505-NAR form, it requires personal information and proof of training.
- Criminal Background Check Authorization: Similar to the 5505-NAR form, this document is necessary for ensuring the safety of patients. It requires the applicant to authorize a background check.
- Nurse Aide Renewal Application: This form is for those who need to renew their certification. It shares similarities with the 5505-NAR in that it collects personal information and proof of continued education.
- Verification of Employment Form: This document verifies an applicant's work experience as a nurse aide. It complements the 5505-NAR form by providing evidence of practical skills and experience in the field.
Dos and Don'ts
When filling out the Texas Nurse Aide Registry 5505-NAR form, it's important to be careful and thorough. Here are some things you should and shouldn't do:
- Do read the instructions carefully before starting the form.
- Do provide accurate personal information, including your name and address.
- Do double-check all entries for spelling and accuracy.
- Do sign and date the form where required.
- Don't leave any required fields blank.
- Don't use abbreviations or nicknames for your name.
- Don't submit the form without reviewing it one last time.
- Don't forget to keep a copy of the completed form for your records.
Misconceptions
There are several misconceptions about the Texas Nurse Aide Registry 5505-NAR form that can lead to confusion. Here are four common misunderstandings:
- Misconception 1: The 5505-NAR form is only for new nurse aides.
- Misconception 2: Submitting the form guarantees certification.
- Misconception 3: The form can be submitted online.
- Misconception 4: There is no deadline for submitting the form.
This is not true. While the form is essential for new applicants, it is also required for those renewing their certification or changing their status.
Filling out the form does not automatically result in certification. The Texas Nurse Aide Registry reviews the application and verifies qualifications before granting certification.
Currently, the 5505-NAR form must be submitted by mail. Online submissions are not accepted, which can catch some applicants off guard.
Applicants must be aware of deadlines. Delays in submission can result in a lapse in certification, which can affect employment opportunities.
Key takeaways
Filling out the Texas Nurse Aide Registry 5505-NAR form is an important step for individuals seeking to become certified nurse aides in Texas. Here are some key takeaways to keep in mind:
- Accurate Information: Ensure that all personal information, including your name, address, and social security number, is filled out accurately. Any discrepancies can lead to delays in processing your application.
- Required Documentation: Be prepared to submit any required documentation along with your form. This may include proof of training or certification, which is essential for verification purposes.
- Submission Process: Understand the submission process. The completed form must be sent to the appropriate address provided in the instructions, and it is wise to keep a copy for your records.
- Follow Up: After submitting your application, follow up with the Texas Nurse Aide Registry to confirm that your application has been received and is being processed. This step can help address any issues that may arise.