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Blank Texas Nurse Aide Registry 5505-NAR Form

The Texas Nurse Aide Registry 5505-NAR form is a crucial document used for the registration and certification of nurse aides in Texas. This form ensures that individuals meet the necessary qualifications to provide care in various healthcare settings. Understanding its purpose and requirements is essential for aspiring nurse aides in the state.

Outline

The Texas Nurse Aide Registry 5505-NAR form plays a pivotal role in the certification process for nurse aides in Texas, ensuring that individuals meet the necessary qualifications to provide care in various healthcare settings. This form is essential for those seeking to become certified nurse aides, as it captures vital information such as personal identification details, educational background, and any relevant training completed. Additionally, it includes sections for applicants to disclose any criminal history or disciplinary actions, which are crucial for maintaining the integrity of the nursing profession. By submitting the 5505-NAR form, aspiring nurse aides not only initiate their journey toward certification but also contribute to the overall safety and quality of care provided to patients. Understanding the nuances of this form is important for applicants, as it outlines the requirements and expectations set forth by the Texas Health and Human Services Commission. With the right information and careful attention to detail, candidates can navigate this process smoothly, paving the way for a fulfilling career in healthcare.

Sample - Texas Nurse Aide Registry 5505-NAR Form

	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: [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:	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 [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.

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Form Information

Fact Name	Description
Purpose of the Form	The Texas Nurse Aide Registry 5505-NAR form is used to apply for or renew certification as a nurse aide in Texas.
Governing Laws	This form is governed by the Texas Health and Safety Code, specifically Chapter 250, which outlines the regulations for nurse aides.
Eligibility Requirements	Applicants must meet specific eligibility criteria, including completion of a state-approved nurse aide training program and passing a competency evaluation.
Submission Process	The completed 5505-NAR form must be submitted to the Texas Health and Human Services Commission, along with any required fees and documentation.
Renewal Frequency	Nurse aide certifications in Texas must be renewed every two years to maintain active status on the registry.

Detailed Guide for Filling Out Texas Nurse Aide Registry 5505-NAR

Filling out the Texas Nurse Aide Registry 5505-NAR form is a straightforward process. After you complete this form, it will be submitted to the appropriate authorities for processing. Make sure you have all necessary information at hand to ensure accuracy and efficiency.

Begin by downloading the Texas Nurse Aide Registry 5505-NAR form from the official website.
Read the instructions carefully to understand the requirements.
Fill in your personal information, including your full name, address, and contact details.
Provide your Social Security number and date of birth as requested.
Indicate your training program details, including the name and address of the institution.
Enter the dates of your training and any relevant certifications you hold.
Sign and date the form at the bottom to confirm the information is accurate.
Double-check all entries for any mistakes or missing information.
Submit the completed form according to the instructions provided, either by mail or online if applicable.

Obtain Answers 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 an official document used for the registration of nurse aides in the state of Texas. It serves as a means to verify that individuals meet the necessary qualifications to work as nurse aides in healthcare facilities.
Who needs to complete the 5505-NAR form?

Individuals who have completed a nurse aide training program and wish to be registered in Texas must complete this form. This includes those seeking employment in nursing homes, assisted living facilities, and other healthcare environments where nurse aides are required.
What information is required on the form?

The form requires personal information such as:
- Full name
- Date of birth
- Social Security number
- Address
- Training program details
Additionally, applicants may need to provide proof of training completion and any other required documentation.
How do I submit the 5505-NAR form?

The completed form can be submitted by mail to the Texas Nurse Aide Registry or, in some cases, electronically through their designated online portal. Ensure that all required documents are included to avoid processing delays.
What is the processing time for the application?

Processing times can vary, but it typically takes between 4 to 6 weeks for the Texas Nurse Aide Registry to review and process applications. It is advisable to apply well in advance of any intended employment start date.
What happens if my application is denied?

If your application is denied, you will receive a notification detailing the reasons for the denial. You may have the opportunity to correct any issues and reapply. It is crucial to address the concerns outlined in the notification to improve your chances of approval.
Can I check the status of my application?

Yes, you can check the status of your application by contacting the Texas Nurse Aide Registry directly. They may provide updates on your application status over the phone or through their online system.
Is there a fee associated with the 5505-NAR form?

Yes, there is typically a fee for processing the application. The exact amount can vary, so it is important to verify the current fee schedule on the Texas Nurse Aide Registry's official website or by contacting them directly.

Common mistakes

Filling out the Texas Nurse Aide Registry 5505-NAR form can be a straightforward process, but many individuals make common mistakes that can lead to delays or complications. One frequent error is providing incomplete personal information. Ensure that all sections, including your name, address, and contact details, are fully filled out. Missing information can result in your application being returned or delayed.

Another mistake is failing to sign and date the form. The signature is crucial as it indicates your acknowledgment of the information provided. Without it, the application may be considered invalid. Always double-check that you have signed and dated the form before submission.

Many applicants also neglect to review the eligibility requirements. It is essential to confirm that you meet all necessary qualifications before submitting your application. This includes verifying your education and training credentials. Submitting an application without meeting these criteria can lead to rejection.

Inaccurate information is another common pitfall. Whether it’s a misspelled name or incorrect social security number, errors can cause significant delays. Take the time to carefully review all details for accuracy. If you are unsure about any information, seek clarification before submitting.

Some individuals forget to include the required documentation. Supporting documents, such as proof of training or identification, must accompany your application. Omitting these can result in processing delays or outright denial of your application.

Another mistake involves not following the submission guidelines. Each application must be sent to the correct address and in the proper format. Ignoring these instructions can lead to confusion and additional delays in processing your application.

Additionally, many applicants overlook the importance of keeping a copy of their application. Retaining a copy can be invaluable if there are questions or issues later in the process. Always make sure to keep a record of what you submitted.

Lastly, some individuals fail to follow up on their application status. After submitting, it is wise to check on the progress of your application. This proactive approach can help address any issues that may arise promptly.

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. Along with this form, several other documents are typically required or helpful in the application process. Below is a list of these documents, each with a brief description to guide you through the requirements.

Background Check Authorization Form: This document allows the state to conduct a criminal background check on the applicant. It is a critical step in ensuring the safety of patients.
Proof of Training Completion: Applicants must provide documentation that verifies they have completed an accredited nurse aide training program. This may include a certificate or transcript.
CPR Certification: A valid certification in cardiopulmonary resuscitation (CPR) is often required. This shows that the applicant is trained in emergency response.
Identification Documents: A government-issued ID, such as a driver's license or passport, is needed to confirm the applicant's identity and residency.
Social Security Card: A copy of the applicant's Social Security card is usually required for verification purposes.
Health Screening Records: Some programs may ask for proof of health screenings, including vaccinations or tests for communicable diseases.
Application Fee Payment Receipt: A receipt showing payment of any required application fees is necessary to process the application.
Employment History Form: This document outlines the applicant's previous work experience, particularly in healthcare settings, to assess their qualifications.

Gathering these documents will help streamline the application process for the Texas Nurse Aide Registry. Being well-prepared can ease any concerns and increase the chances of a successful application. Make sure to review each requirement carefully and seek assistance if needed.

Similar forms

The Texas Nurse Aide Registry 5505-NAR form is essential for individuals seeking certification as nurse aides in Texas. Several other documents serve similar purposes in various contexts. Below is a list of these documents and their similarities to the 5505-NAR form:

Certified Nursing Assistant (CNA) Application Form: This form is used by individuals applying for CNA certification. Like the 5505-NAR, it collects personal information and details about training and education.
State Nurse Aide Registry Application: Similar to the 5505-NAR, this document registers nurse aides in their respective states, ensuring compliance with state regulations and standards.
Background Check Authorization Form: This form is often required for nurse aide certification. It ensures that applicants undergo necessary background checks, similar to the verification processes in the 5505-NAR.
Continuing Education Verification Form: This document verifies that nurse aides have completed required continuing education, akin to the training verification aspect of the 5505-NAR.
Employment Verification Form: Used to confirm an applicant's work history, this form parallels the employment section of the 5505-NAR, which may require similar information.
Recertification Application: For nurse aides seeking to renew their certification, this application shares similarities with the 5505-NAR in terms of required documentation and personal information.
Training Program Completion Certificate: This certificate confirms that an individual has completed a nurse aide training program. It relates to the 5505-NAR's focus on educational qualifications.

Dos and Don'ts

When filling out the Texas Nurse Aide Registry 5505-NAR form, it's essential to follow certain guidelines to ensure accuracy and compliance. Here are five things you should and shouldn't do:

Do read the instructions carefully before starting the form.
Do provide accurate and complete personal information.
Do double-check your application for any errors before submission.
Don't leave any required fields blank.
Don't submit the form without reviewing all attached documents.

Following these guidelines will help ensure a smoother application process and reduce the likelihood of delays or issues with your registration.

Misconceptions

Misconceptions about the Texas Nurse Aide Registry 5505-NAR form can lead to confusion among aspiring nurse aides. Understanding these misconceptions is crucial for anyone navigating the certification process. Below are nine common misunderstandings.

The form is only for new applicants. Many believe the 5505-NAR form is solely for first-time applicants. In reality, it is also used for renewals and updates to existing registrations.
Only Texas residents can apply. Some think that only individuals residing in Texas can submit the form. However, applicants from other states can also apply if they meet the necessary criteria.
Submission of the form guarantees certification. A common belief is that merely submitting the 5505-NAR form ensures certification as a nurse aide. Certification is contingent upon meeting all requirements, including passing the competency exam.
The form is difficult to complete. Many individuals feel intimidated by the form, thinking it is overly complex. In fact, the form is designed to be straightforward, and guidance is available for those who need assistance.
There is no deadline for submission. Some applicants assume they can submit the form at any time without consequence. However, there are specific deadlines, especially for those seeking employment in a timely manner.
Only certain educational programs are recognized. It is a misconception that only specific training programs qualify for the 5505-NAR form. The registry accepts a variety of accredited programs that meet state standards.
Background checks are not necessary. Some believe that background checks are optional when submitting the form. In fact, a criminal background check is a mandatory part of the application process.
The form can be submitted online only. There is a notion that the 5505-NAR form must be submitted electronically. Applicants can also submit a paper form by mail if they prefer.
All information on the form is public. Many think that all details provided on the form are accessible to the public. In reality, personal information is protected and only shared with authorized parties.

Clarifying these misconceptions can help aspiring nurse aides navigate the certification process more effectively. Understanding the requirements and procedures associated with the Texas Nurse Aide Registry is essential for success in this field.

Key takeaways

When filling out and using the Texas Nurse Aide Registry 5505-NAR form, it's essential to keep a few key points in mind. Here are ten important takeaways:

Understand the Purpose: The form is used to apply for certification as a nurse aide in Texas.
Gather Required Information: Before starting, ensure you have all necessary personal and educational details on hand.
Complete All Sections: Fill out every section of the form thoroughly to avoid delays in processing.
Use Clear and Accurate Information: Double-check all entries for accuracy, as mistakes can lead to complications.
Signature Requirement: Don’t forget to sign and date the form; an unsigned application will be rejected.
Submit on Time: Pay attention to submission deadlines to ensure your application is processed promptly.
Payment Information: Include any required fees with your application to avoid delays.
Keep Copies: Make copies of your completed form and any supporting documents for your records.
Follow Up: After submission, consider checking the status of your application to ensure everything is in order.
Stay Informed: Keep up with any changes in the application process or requirements by regularly visiting the Texas Nurse Aide Registry website.

By following these key takeaways, you can navigate the application process more smoothly and increase your chances of a successful certification as a nurse aide in Texas.