How to Submit Forms and
Applications
Complete and submit the following forms and applications by email to [email protected].
- Registry Change Request Form
- Reciprocity Application
- Licensed Nurse Form
The Division of Health Service Regulation has partnered with Credentia to process training waiver requests. To request a training waiver, complete and submit the following application through Credentia’s system.
- Training Waiver Application
Complete and submit the following forms online through the Division of Health Service Regulation.
- Nurse Aide Online Renewal Form
- Nurse Aide Online Employment Verification Form
- Medication Aide Online Renewal Form
- Medication Aide Online Employment Verification Form
Review the following guidelines before completing the online renewal forms:
Denotes link to site outside of N.C. DHHS
