Texas Nurse Aide Registry 5505-NAR Template Access Texas Nurse Aide Registry 5505-NAR Editor Now

Texas Nurse Aide Registry 5505-NAR Template

The Texas Nurse Aide Registry 5505-NAR form is a vital document for nurse aides in Texas, facilitating the official processes required for certification and employment within the state. This form serves as an application for individuals seeking to establish or maintain their status on the Texas Nurse Aide Registry, an essential step for those wishing to work in this capacity. For those ready to advance their career in healthcare, ensure accuracy and completeness when filling out this form by clicking the button below.

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Table of Contents

The Texas Nurse Aide Registry 5505-NAR form plays a crucial role for individuals working or planning to work as nurse aides in the state of Texas. This form is instrumental in ensuring that nurse aides are correctly registered, a requirement that upholds both the safety of patients and the integrity of the healthcare system. Completing and submitting this form is the first step for anyone aiming to become a certified nurse aide (CNA) in Texas, as it contains necessary information for the verification of one’s qualifications and credentials. Moreover, the 5505-NAR form is not just for new applicants; it also serves existing CNAs who need to renew or update their registry status. This might involve changes in personal information, work status, or compliance with continuing education requirements. Thus, this form is a key document that ensures nurse aides are competent, up-to-date with their training, and legally authorized to work in Texas healthcare facilities.

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Texas Nurse Aide Registry

Form 5505-NAR

December 2022-E

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: nurseaideregistry@hhs.texas.gov (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:

Date of Birth:

Email Address:

 

Male

Female

 

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 nurseaideregistry@hhs.texas.gov.

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 Breakdown

Fact Description
Form Name Texas Nurse Aide Registry 5505-NAR Form
Purpose Used for the application, renewal, or transfer of a nurse aide certification in Texas.
Governing Law Regulated under Texas Health and Safety Code and Texas Administrative Code, Title 40, Part 1.
Agency The form is managed by the Texas Department of Health and Human Services (HHS).
Who Must Complete Individuals seeking to work as certified nurse aides in Texas must complete this form.
Renewal Requirement Certification must be renewed every two years, requiring continued employment and training.
Additional Requirements Applicants may need to pass a background check, a competency evaluation, and meet training requirements.
Accessibility The form is accessible online through the Texas Health and Human Services website or can be requested by mail.

Guidelines on Filling in Texas Nurse Aide Registry 5505-NAR

Filling out the Texas Nurse Aide Registry 5505-NAR form is a critical step for individuals aiming to formalize their status and recognition in the healthcare sector in Texas. The completion and submission of this form are essential for those who have completed their training and competency evaluation program and are seeking to be listed on the Texas Nurse Aide Registry. This registry is instrumental for employment in long-term care facilities, as it verifies an aide's qualifications to employers. Understanding how to correctly fill out this form is key to avoiding delays or issues in the certification process. The following steps will guide you through the process to ensure your form is accurately completed and submitted.

  1. Start by entering your full legal name, including your first, middle, and last name, to ensure your certification is correctly attributed to you.
  2. Provide your social security number next. This unique identifier is crucial for tracking your application and status within the registry.
  3. Include your date of birth in the format of MM/DD/YYYY. This helps in verifying your eligibility and maintaining accurate records.
  4. List your current mailing address, including street, city, state, and zip code, so any correspondence or certification materials can be sent to you without delay.
  5. Specify your telephone number, including the area code, to facilitate prompt communication regarding your application or any additional requirements.
  6. Indicate your email address. Many communications and notifications are handled electronically, making an accurate email address essential.
  7. Detail your nursing assistant training information, including the name and address of the training program, the completion date, and the total number of hours completed. This verifies that you have met the educational requirements.
  8. For those who have already passed their competency evaluation, enter the date of passing. This demonstrates that you have successfully completed all requirements for registry listing.
  9. Sign and date the form in the designated sections. Your signature confirms the accuracy of the information provided and your consent to the submission of the form.
  10. Review the entire form to ensure all information is correct and no sections have been missed. A complete check will prevent processing delays.

Once the form is fully completed, submit it to the address provided on the form. Keep a copy for your records. The processing of your application will commence, laying the groundwork for your recognition and employment in the Texas healthcare system. Timely submission and careful attention to detail on the form will streamline the approval process, bringing you one step closer to your professional goals in the nursing field.

Learn More on Texas Nurse Aide Registry 5505-NAR

What is the Texas Nurse Aide Registry 5505-NAR form?

The Texas Nurse Aide Registry 5505-NAR form is a critical document utilized by nurse aides in the state of Texas. This form is used to record and submit essential information regarding their certification and employment status to the Texas Nurse Aide Registry. It serves as a means of ensuring that all practicing nurse aides are duly registered and compliant with state regulations for health care providers.

How can I obtain the 5505-NAR form?

Obtaining the 5505-NAR form is straightforward. Interested individuals can download it directly from the Texas Health and Human Services (HHS) website. Alternatively, one can request a physical copy by contacting the Texas Nurse Aide Registry through their official contact channels. It's vital to ensure that the most current version of the form is used to avoid any processing delays.

Who needs to fill out the 5505-NAR form?

The 5505-NAR form must be filled out by:

  • Nurse aides seeking to renew their certification in Texas.
  • Individuals applying for a nurse aide certification in Texas for the first time.
  • Nurse aides who are required to update their employment status or personal details.
This form is an essential step in maintaining active status within the Texas Nurse Aide Registry.

What information is required on the 5505-NAR form?

Completing the 5505-NAR form requires several pieces of information, including but not limited to:

  1. Full legal name and social security number of the nurse aide.
  2. Current mailing address and contact information.
  3. Employment history as a nurse aide, including facility names, addresses, and dates of employment.
  4. Details of any changes in personal information such as name changes or address updates.
  5. Signature of the nurse aide, certifying the accuracy and completeness of the information provided.
It's crucial to provide accurate and up-to-date information to ensure the timely processing of the form.

How do I submit the completed 5505-NAR form?

The completed 5505-NAR form can be submitted in one of several ways:

  • By mail: Send the original completed form to the address specified on the form or the instructions accompanying it.
  • By fax: If permitted, fax the form to the number provided by the Texas Nurse Aide Registry.
  • Online: Some users may have the option to submit their forms through an online portal if available via the Texas Health and Human Services website.
Before submission, ensure the form is filled out comprehensively and legibly to avoid any delays in processing.

What happens after the 5505-NAR form is submitted?

After the 5505-NAR form is submitted, the Texas Nurse Aide Registry will review the submitted information for completeness and accuracy. This process involves:

  • Verifying the nurse aide's eligibility for certification or recertification.
  • Updating the nurse aide's record in the registry, including any changes in employment or personal details.
  • Issuing a new certification or recertification confirmation, if applicable.
Applicants will receive a notification regarding the status of their submission and any next steps. It's important to keep a copy of the form and any correspondence for personal records.

Common mistakes

Filling out the Texas Nurse Aide Registry 5505-NAR form is a crucial step for nurse aides seeking certification or renewal in the state of Texas. However, individuals often make mistakes during this process. Here are four common errors to avoid:

  1. Not reviewing the form for completeness: A frequent error is submitting the form without ensuring all required fields are filled. Every section of the 5505-NAR form serves a purpose, and leaving blank spaces can delay processing.

  2. Overlooking the signature and date sections: It's essential to sign and date the form. This oversight can invalidate the submission, as an unsigned form is often considered incomplete or unverified.

  3. Incorrect Information: Mistakes such as transposing numbers in contact information or providing outdated addresses can hinder communication. Ensuring accuracy in personal details is crucial for a smooth verification process.

  4. Failing to attach required documents: The application process often requires additional documentation, such as proof of training or identification. Neglecting to attach these documents can result in processing delays or denials.

To avoid these errors, applicants should take the time to carefully review their forms and ensure they meet all requirements before submission. Attention to detail and adherence to instructions can significantly streamline the certification process, helping nurse aides achieve their professional goals more efficiently.

Documents used along the form

When working with the Texas Nurse Aide Registry 5505-NAR form, it's important to understand that there are several other forms and documents that may often be utilized in tandem with it. These documents are designed to ensure that nurse aides have the necessary certifications, background checks, and health documentation required for employment in patient care settings. This brief overview highlights some key documents often associated with the 5505-NAR form.

  • Employment Eligibility Verification (Form I-9): This form is used to verify the identity and employment authorization of individuals hired for employment in the United States. It is critical for nurse aides to complete this form to ensure legal work status.
  • Criminal History Check Consent Form: This document is necessary for conducting background checks on nurse aides to ensure they have no criminal history that would disqualify them from working with vulnerable populations.
  • Tuberculosis (TB) Test Documentation: Given the close contact with patients, nurse aides must prove they are free of TB. This document provides evidence of either a negative TB skin test or a clear chest x-ray.
  • Certification of Health Status Form: This form is filled out by a healthcare provider to assert that a nurse aide is in good health and capable of performing the duties of the job without posing a risk to patients.
  • Continuing Education Units (CEUs) Documentation: Nurse aides are required to complete ongoing education to maintain their certification. This document proves that the required CEUs have been completed.
  • Basic Life Support (BLS) Certification: This certification shows that a nurse aide has been trained in basic life support and cardiopulmonary resuscitation (CPR), which are critical skills in many patient care settings.
  • Skills Competency Evaluation Form: After completing the necessary education, this form is used to document a nurse aide's competence in the practical skills required for their certification and job role.

Each of these documents plays a critical role in ensuring that the individuals working as nurse aides are qualified, healthy, and legally authorized to do so. Combining these documents with the Texas Nurse Aide Registry 5505-NAR form creates a comprehensive profile of each aide's credentials, ensuring high standards of care for patients across Texas.

Similar forms

  • Certified Nursing Assistant (CNA) Examination Application: This document is similar to the Texas Nurse Aide Registry 5505-NAR form in that both are initial steps for individuals seeking certification or registration in nursing or related healthcare fields. They require personal information, education background, and possibly evidence of training completion.

  • Emergency Medical Technician (EMT) Certification Application: Like the 5505-NAR form, this document is necessary for individuals pursuing licensure in emergency medical services. It collects detailed information on the applicant's training, competency, and qualifications, ensuring they meet the standards required for the profession.

  • Medical License Application: Physicians and surgeons use this form to apply for permission to practice in a given state. It resembles the 5505-NAR form because it includes verification of education, training, and exams, as well as personal identification and background checks to ensure the applicant's fitness for the profession.

  • Pharmacy Technician Registration Form: Pharmacy technicians must fill out this form to work in pharmacies. It is similar to the 5505-NAR form in its requirement for personal information, education, and proof of completed pharmacy technician training programs, ensuring candidates are prepared for their roles.

  • Physical Therapist Licensing Application: This application is required for individuals seeking to practice physical therapy. It parallels the 5505-NAR form in collecting detailed educational backgrounds, clinical training experiences, and examination records to verify the applicant's qualifications and readiness for professional practice.

Dos and Don'ts

When completing the Texas Nurse Aide Registry 5505-NAR form, attention to detail is crucial. This document ensures that nurse aides are properly listed in the Texas Registry, which is essential for their careers. The following are guidelines to help ensure the form is filled out correctly and efficiently:

Do:

  1. Read the instructions carefully before starting. Understanding each section will help avoid mistakes and ensure the form is completed correctly.
  2. Use black ink when filling out the form. This makes the information clear and legible, ensuring there is no confusion or misinterpretation of the details provided.
  3. Verify all personal information for accuracy. Double-check your spelling, especially for names and addresses, to ensure your record is accurate and matches other official documents.
  4. Sign and date the form in the designated sections. An unsigned or undated form may be considered invalid and could delay the processing.
  5. Keep a copy for your records. Having a personal copy means you have proof of submission, which can be helpful if there are any questions or issues down the line.
  6. Contact the Texas Nurse Aide Registry if you have any questions before submitting the form. This can prevent mistakes that could delay your certification or listing.

Don't:

  • Do not use pencil or non-black ink. These can smear or fade, making your form hard to read and possibly leading to processing delays or errors.
  • Do not leave required fields blank. If a section does not apply to you, write "N/A" (not applicable) rather than leaving it empty. This indicates that you did not accidentally skip the question.
  • Do not provide false information. Falsifying information on official documents can lead to serious consequences, including denial of certification or legal action.
  • Do not forget to include necessary attachments or documentation. Check the requirements and make sure everything needed is submitted together with your form.
  • Do not use correction fluid or tape. Mistakes should be neatly crossed out with a single line, and the correct information should be clearly written next to it or above it.
  • Do not rush through filling out the form. Taking your time can help prevent errors and ensure that all information is accurate and complete.

Misconceptions

When discussing the Texas Nurse Aide Registry 5505-NAR form, several misconceptions commonly arise. Understanding these misconceptions is critical to ensuring accurate completion and submission of this important document.

  • It's only for first-time applicants: A common misconception is that the 5505-NAR form is exclusively for individuals applying to become nurse aides for the first time. In reality, this form is also used for renewing listings and reporting changes such as name or address updates.

  • A passing exam score automatically updates your status: Many believe that once they pass the nurse aide competency exam, their status is automatically updated in the registry. However, individuals must submit the 5505-NAR form to the Texas Nurse Aide Registry to update their status officially.

  • No need to report employment: There's a misconception that nurse aides do not need to report their employment to maintain their listing. In truth, employment verification, as a nurse aide performing nursing or nursing-related services, is required for renewal, and this information must be submitted through the 5505-NAR form.

  • Electronic submission is available: While many government forms are moving towards electronic submission, the 5505-NAR form must be submitted through mail or fax as per current requirements. Assuming it can be submitted electronically can lead to delays in processing.

  • The form is unnecessary for those trained in other states: Another common mistake is the belief that nurse aides trained in other states do not need to complete the 5505-NAR form when working in Texas. Regardless of where you were trained, this form is required to document your eligibility and work status in Texas.

  • Immediate processing of the form: People often expect that their 5505-NAR forms will be processed immediately upon receipt. Due to the volume of submissions and verification processes, processing times can vary, and patience is required.

Dispelling these misconceptions is important for current and prospective nurse aides to ensure they meet all requirements for certification and maintain valid listings on the Texas Nurse Aide Registry.

Key takeaways

The Texas Nurse Aide Registry 5505-NAR form is essential for nurse aides in Texas who wish to be listed on the registry, an important step in their career. Understanding the key aspects of filling out and utilizing this form can significantly streamline the process. Below are nine key takeaways for those navigating this essential documentation.

  1. Ensure all personal information is accurate and up-to-date, including your full legal name and contact details, as the Texas Nurse Aide Registry uses this information for all official communications and verification purposes.

  2. Complete the form in its entirety. Each section must be filled out thoroughly, as missing information can lead to delays in processing or outright rejection.

  3. Pay close attention to the sections that require a signature. Unsigned forms are not processed, which can impede your registration or renewal on the registry.

  4. Include documentation of your training and examination certifications. These documents serve as proof of your qualifications and are necessary for your inclusion on the registry.

  5. If applicable, document any name changes (due to marriage, divorce, or other reasons) since last registering. This ensures that your record is current and minimizes confusion.

  6. Understand the renewal process, as it is crucial for maintaining your listing on the registry. Note the expiration date of your certification and submit renewal applications well in advance.

  7. Keep copies of the form and all accompanying documents for your records. Having your own records can be helpful for personal tracking and in case of any discrepancies with the registry’s records.

  8. Be aware of the processing time for the application. While the Texas Nurse Aide Registry works to process forms promptly, it’s advisable to allow ample time for processing to avoid lapses in certification.

  9. If you have any questions about the form or the process, contact the Texas Nurse Aide Registry directly. Their staff can provide assistance and guidance to ensure your documentation is correctly completed and submitted.

Remember, the successful completion and submission of the Texas Nurse Aide Registry 5505-NAR form is a critical step in your career as a nurse aide. Following these tips can help secure your place on the registry and ensure compliance with state regulations.

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