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DHHS Form DHHS/DHSR/HCPR-4510 2010 free printable template

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N.C. Department of Health and Human Services. HHS/DSR/HCPR-4510 (Rev. 10-2010). NURSE AIDE I'm TRAINING PROGRAM APPLICATION PACKET ...
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DHHS Form DHHS/DHSR/HCPR-4510 Form Versions

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How to fill out DHHS Form DHHSDHSRHCPR-4510

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How to fill out DHHS Form DHHS/DHSR/HCPR-4510

01
Obtain the DHHS Form DHHS/DHSR/HCPR-4510 from the official website or designated office.
02
Read the instructions carefully to understand the requirements of the form.
03
Fill out the applicant's information section with accurate personal details.
04
Provide the necessary information regarding the healthcare facility or service.
05
Complete the sections related to the applicant's qualifications and experience.
06
Attach any required documents or certifications that support the application.
07
Review all entries for accuracy and completeness before submission.
08
Sign and date the form as required.
09
Submit the completed form to the appropriate department as instructed.

Who needs DHHS Form DHHS/DHSR/HCPR-4510?

01
Healthcare providers seeking licensure or certification.
02
Organizations applying for approval to operate healthcare facilities.
03
Individuals applying for a specific healthcare-related position or credential.
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There are two ways for individuals who are certified in another state to become listed on the Nursing Aide Registry in North Carolina. You can take the Nurse Aide I training (or comparable) and pass the competency test or pass the state approved Nursing Aide I competency test.
How long does it take to be listed on the registry after I complete the state-approved exam? Individuals are listed on the North Carolina Nurse Aide I Registry within 10 business days after successfully completing the North Carolina state-approved Nurse Aide I competency exam.
If your Nurse Aide II listing expired in the past 24 months, you are required to successfully complete the competency evaluation portion of the Nurse Aide II Program to be eligible for renewal.
There is no fee required to complete the online renewal form. If you do not meet the following eligibility requirements, then you are not eligible for renewal. Nurse aides working in a non-nursing home setting are responsible for making sure their job duties qualify for renewal.
On-time renewal of licensure will be for two (2) years and will expire the last day of your birth month. For initial licensure or reinstatement of a lapsed license, licensure may be for less than two (2) years [13-24 months] in order to place the expiration on the birth month.
To become a Nurse Aide I, one must do one of the following: Pass state-approved Nurse Aide I training and competency testing. Pass state-approved Nurse Aide I competency testing once a training waiver has been reviewed and approved. Request listing based on a qualified N.C. nursing license.

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DHHS Form DHHS/DHSR/HCPR-4510 is a documentation form required by the Department of Health and Human Services (DHHS) for reporting specific healthcare-related information.
Healthcare providers and organizations operating in North Carolina that are governed by DHHS regulations are required to file DHHS Form DHHS/DHSR/HCPR-4510.
To fill out DHHS Form DHHS/DHSR/HCPR-4510, follow the instructions provided with the form, ensuring to complete all sections accurately, including provider details, patient information, and any required narratives.
The purpose of DHHS Form DHHS/DHSR/HCPR-4510 is to collect and report data that helps ensure compliance with healthcare regulations and improves the quality of care provided within the state.
The information that must be reported on DHHS Form DHHS/DHSR/HCPR-4510 includes provider identification, service details, patient demographics, and any incidents or issues related to care.
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