Applications, Forms & Fees
- Application – there is none for nurse aides
- Fees – there is none for nurse aides
- Interstate Endorsement – Complete this form if you are a nurse aide in another state and transferring/moving to Nebraska and want to work in Nebraska.
- Employment Verification Form –submit employment information when working private duty or out-of-state employment.
- Name Change/License Reissue Form – There is no charge for nurse aides changing their name. Attach to the form a copy of the document that proves your name change.
- Address Change
- Registry Form – Updated form as of 7/25/17. To be submitted by the facility employer upon hire of a nurse aide.
- End of Employment/Termination Form – submitted by employer when nurse aide no longer works for them
- List/roster of nurse aides working for an employer – list of nurse aides presently employed at a specific setting according to the nurse aide registry
- updated weekly on Friday
- Search alpha to city, then alpha to employer, than alpha to nurse aide’s last name
- Search and print the individual facility’s list carefully as it is over 1100 pages
- May use for submission of end of employment/termination information
- Abuse In-Service training – to be used for documentation by the employer or college of completion of the training for a nurse aide transferring to Nebraska from another state.