DHHS Form DHHS/DHSR/HCPR-4510 2014 free printable template
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2709 Mail Service Center Raleigh, NC 27699-2709 Division of Health Service Regulation Center for Aide Regulation and Education Branch N.C. Health Care Personnel Registry Section Phone: 919-855-3970
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How to fill out DHHS Form DHHSDHSRHCPR-4510
How to fill out DHHS Form DHHS/DHSR/HCPR-4510
01
Obtain a copy of DHHS Form DHHS/DHSR/HCPR-4510.
02
Read the instructions provided with the form carefully.
03
Fill out the applicant’s name at the top of the form.
04
Provide the address of the applicant, including city, state, and zip code.
05
Enter the phone number of the applicant.
06
Indicate the reason for completing the form in the designated section.
07
Fill out the appropriate details in the sections regarding service requests and background information.
08
Review the form for completeness and accuracy.
09
Sign and date the form at the bottom.
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Submit the completed form as directed in the instructions.
Who needs DHHS Form DHHS/DHSR/HCPR-4510?
01
Individuals applying for licensure or certification in health care-related fields.
02
Organizations seeking to provide health care services.
03
Regulated entities under DHHS that require compliance documentation.
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People Also Ask about
How do I transfer my CNA license to North Carolina?
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 get on the N.C. nurse aide Registry?
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.
Can you renew your CNA license after it expires in North Carolina?
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.
Can I renew my CNA license online North Carolina?
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.
How often do you have to renew your CNA in North Carolina?
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.
What are the requirements for an individual to be listed on the N.C. nurse aide 1 registry?
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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What is DHHS Form DHHS/DHSR/HCPR-4510?
DHHS Form DHHS/DHSR/HCPR-4510 is a form used by healthcare providers to report certain information to the Department of Health and Human Services.
Who is required to file DHHS Form DHHS/DHSR/HCPR-4510?
Healthcare providers and facilities that are regulated by the Department of Health and Human Services must file DHHS Form DHHS/DHSR/HCPR-4510.
How to fill out DHHS Form DHHS/DHSR/HCPR-4510?
To fill out DHHS Form DHHS/DHSR/HCPR-4510, gather the necessary information about your facility, complete all required sections, and submit it according to the instructions provided by DHHS.
What is the purpose of DHHS Form DHHS/DHSR/HCPR-4510?
The purpose of DHHS Form DHHS/DHSR/HCPR-4510 is to ensure compliance with regulatory requirements and to facilitate the collection of data related to healthcare services.
What information must be reported on DHHS Form DHHS/DHSR/HCPR-4510?
The form requires reporting information such as the name and address of the facility, types of services provided, number of patients served, and other relevant operational details.
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