How to Submit Forms and Applications

Email the following forms and applications to the Division of Health Service Regulation at [email protected]. You must submit the most current version of each form and application.

Complete the following application using Credentia’s CNA365 system.  Click here to go to Credentia’s website. 

Complete the following forms online at the Division of Health Service Regulation website:

Nurse Aide and Medication Aide Guidelines:

Technology Guidelines:

First Name and Last Name Requirements:

Registered Nurse Guidelines:

Link goes outside of N.C. DHHS. Denotes link to site outside of N.C. DHHS