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MI LARA/CNA-500 2012 free printable template

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LARA/CNA-500 (5/11) Michigan Department of Licensing and Regulatory Affairs Bureau of Health Professions P.O. Box 30670 Lansing, MI 48909 www.michigan.gov/healthlicense REQUEST FOR EXEMPTION FROM
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How to fill out michigan nurse aide exemption

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How to fill out Michigan nurse aide exemption:

01
Visit the Michigan Department of Licensing and Regulatory Affairs (LARA) website.
02
Locate the "Nurse Aide Registry" section on the website.
03
Download the Michigan Nurse Aide Exemption form.
04
Fill out the form with accurate personal information, including name, address, and contact details.
05
Provide details about your current employment or educational status that exempts you from becoming a Michigan nurse aide.
06
Attach any necessary supporting documents, such as proof of enrollment in a nursing program or evidence of current employment in a related healthcare field.
07
Review the completed form and supporting documents to ensure they are accurate and complete.
08
Submit the filled out form and supporting documents to the address specified on the form or through the online submission method, if available.

Who needs Michigan nurse aide exemption:

01
Individuals who are currently enrolled in a nursing program and will graduate as a registered or licensed practical nurse.
02
Individuals who are employed in a healthcare-related profession that does not require nurse aide certification but have comparable skills and knowledge.
03
Individuals who have previously been certified as a nurse aide in another state and are now applying for reciprocity in Michigan.
Note: It is essential to consult the official Michigan Department of Licensing and Regulatory Affairs (LARA) website or contact them directly for the most accurate and up-to-date information regarding the Michigan nurse aide exemption process.

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The Michigan nurse aide exemption is a provision that allows individuals who have completed a nurse aide training program in another state to become exempt from completing the Michigan nurse aide training and competency evaluation program. This exemption applies to individuals who have completed their training within the past two years and have not worked as a nurse aide for more than 24 consecutive months. These individuals can apply for exemption and are eligible to work as nurse aides in Michigan without having to complete the state's required training and competency evaluation program.
The individual who is required to file a Michigan Nurse Aide exemption is a nurse aide who meets certain educational or training criteria and wishes to be exempted from taking the nurse aide competency evaluation program in Michigan.
To fill out the Michigan Nurse Aide exemption, you will need to follow these steps: 1. Obtain the Michigan Nurse Aide Exemption Application form. You can find this form on the Michigan Department of Licensing and Regulatory Affairs (LARA) website or by contacting the LARA directly. 2. Read through the instructions provided with the form to understand the requirements and eligibility criteria for exemption. 3. Provide your personal information in the designated sections of the form. This may include your full name, date of birth, social security number, address, and contact information. 4. Indicate your reason for requesting exemption from nurse aide listing in Michigan. The form will typically have checkboxes or spaces where you can explain the specific reason for your exemption request. 5. Attach any supporting documentation to substantiate your exemption claim. For example, if you have completed a nursing program or have a current active certification as a nurse, you may need to provide certificates or other proof of your qualifications. 6. Sign and date the form at the bottom to certify the accuracy of the information provided. 7. Make a copy of the completed application for your records. 8. Submit the form and any required documentation to the Michigan Department of Licensing and Regulatory Affairs according to the instructions provided. This may involve mailing the application or submitting it online, depending on the specific requirements outlined on the form. It is important to carefully follow the instructions provided on the form and ensure that you provide all necessary information and documentation to support your exemption request. If you have any doubts or questions, it is advisable to contact the LARA for clarification or assistance.
The purpose of the Michigan nurse aide exemption is to allow individuals who have completed nurse aide training and competency evaluation programs in other states to be exempt from retaking the training and competency evaluation program in Michigan. This exemption ensures that qualified nurse aides from other states can work in Michigan without having to repeat the training and evaluation process.
According to the Michigan Department of Licensing and Regulatory Affairs (LARA), the following information must be reported on a Michigan Nurse Aide Exemption: 1. Applicant's full legal name and any previous names used 2. Applicant's date of birth 3. Applicant's social security number 4. Applicant's contact information (address, phone number, email) 5. Employment history as a nurse aide or related healthcare worker, including the name and address of employer, dates of employment, and position held 6. Reason for seeking exemption from nurse aide training and competency evaluation, such as previous nursing education, military training, or equivalent training/competency evaluation in another state 7. Relevant certifications, licenses, or registrations held (if applicable) 8. Sworn statement indicating the truth and accuracy of the information provided, with the understanding that false statements may result in denial of exemption or disciplinary action It is important to note that this information may be subject to change, and it is advisable to refer to the official guidelines provided by LARA for the most up-to-date requirements.
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