Article Structure
The Texas Nurse Aide Registry Form 5506-NAR is a vital document for Certified Nurse Aides (CNAs) seeking recertification and employment verification. This form is structured into two main sections: the first section requires the nurse aide to provide detailed personal information, including their name, address, social security number, and certification details. Additionally, applicants must confirm their education and employment history, particularly addressing any past convictions that may classify them as unemployable. Importantly, completing this section accurately and signing it is crucial, as any errors or omissions may result in the Texas Nurse Aide Registry returning the form without action. The second section is dedicated to employer verification, where the nurse aide’s employer confirms their employment status and provides a notarized signature. The form must be emailed to the Nurse Aide Registry for processing, and applicants must be prepared to submit additional documentation if requested. This includes verification of in-service education and any specific training courses, which are subject to audit. Understanding the requirements and ensuring accurate completion of Form 5506-NAR can significantly impact a nurse aide's ability to maintain their certification and remain eligible for employment in Texas's healthcare system.
Texas 5506 Nar Example
Texas Nurse Aide Registry |
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Employment Verification |
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Section 1 (To be completed by Nurse Aide. Please read the following instructions before completing this form.)
•Complete all information in Section 1 and sign to verify that the information provided is correct.
•Obtain employer verification (Section 2). Form must be emailed to Texas Nurse Aide Registry at: nurseaideregistry@hhs.texas.gov. To verify your
Certified Nurse Aide (CNA) certification, use the following link: https://emr.dads.state.tx.us/DadsEMRWeb/.
Note: A list of approved
Name of Applicant (Last, First, Middle): |
Maiden Name (if applicable): |
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Mailing Address (Street or P.O. Box):
City:
Social Security No.:
Email Address:
State: |
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ZIP Code: |
Daytime Phone No. with Area Code: |
Sex: |
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Date of Birth: |
CNA Certificate No.: |
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Female |
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Verification of requirements for Nurse Aide Recertification
Are you listed on the Employee Misconduct Registry (EMR) as unemployable? |
Yes |
No |
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Have you been found to have a conviction of a criminal offense listed in Texas Health and Safety Code, §250.006? |
Yes |
No |
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If yes, give date of conviction. |
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Have you completed 24 hours of |
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No |
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Note:
Have you completed an HHSC course in infection control and proper use of personal protective equipment (PPE) once each year |
Yes |
No |
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in the past 24 months? |
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Signature – Nurse Aide |
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Section 2 (To be completed by the Employer – Instructions)
•This section must be completed by the facility program director, official keeper of records or actual employer.
•Notarize employer signature at the bottom of this section and return to nurse aide.
Employer Name or Company Name: |
Daytime Area Code and Phone No.: |
Mailing Address (Street or P.O. Box):
City:
State:
ZIP Code:
I certify that the individual named above is/was employed by me as a nurse aide and performed |
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and that I am not aware of any disqualifying misconduct. |
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Signature – Employer |
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Sworn and subscribed to me on this |
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day of |
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Signature – Notary Public |
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Date Commission Expires |
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Place Notary Seal or Stamp Here |
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Tampering with, or attempting to falsify, a government record such as a nurse aide certificate is a
Form
Page 2 /
Address:
•Did you sign and complete all information in Section 1?
•Did your employer notarize his/her signature in Section 2?
Did you know?
•You can verify certificate status by using the following link: https://emr.dads.state.tx.us/DadsEMRWeb/.
•You can download forms from our website:
Email the completed form and required documents to the Texas Nurse
Aide Registry at nurseaideregistry@hhs.texas.gov
With a few exceptions, you have the right to request and be informed about the information that the Texas Health and Human Services Commission (HHSC) obtains about you. You are entitled to receive and review the information upon request. You also have the right to ask HHSC to correct information that is determined to be incorrect (Government Code, Sections 552.021, 552.023, 559.004). To find out about your information and your right to request correction, please contact the Nurse Aide Registry at
Form Characteristics
| Fact Name | Details |
|---|---|
| Purpose of Form | The Texas Nurse Aide Registry Form 5506-NAR is designed for nurse aides to verify employment and fulfill recertification requirements. |
| Governing Laws | This form operates under Texas Health and Safety Code, §250.006, which addresses the requirements for nurse aide certification and recertification. |
| Email Submission | Completed forms should be sent via email to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov. |
| In-Service Education Requirement | Nurse aides must complete 24 hours of in-service education within the last two years to maintain certification. |
| Consequences for Tampering | Attempts to falsify the form or any related documentation can lead to severe legal consequences, including a third-degree felony charge. |
Guidelines on Utilizing Texas 5506 Nar
Filling out the Texas 5506 NAR form is an important process for nurse aides seeking recertification. It involves providing personal information and obtaining employer verification. Once the form is complete and submitted, it will be processed by the Texas Nurse Aide Registry, allowing for a continued career in nursing aide services.
- Gather your personal information: You will need your full name (including maiden name if applicable), mailing address, social security number, email address, daytime phone number, sex, date of birth, and CNA certificate number.
- Complete Section 1: Fill out all required fields regarding your employment verification and personal information. Ensure you read and understand each question, especially those related to your criminal history and in-service education.
- Sign Section 1: After verifying all information is correct, sign and date the form to confirm accuracy.
- Contact your employer: Provide the form to your employer for completion of Section 2. This section must be filled out by your facility’s program director or the official keeper of records.
- Employer’s verification: Your employer must indicate their name, phone number, address, and employment dates, sign the section, and ensure it is notarized.
- Review the completed form: Double-check both sections to ensure all information is complete and accurate. Make sure your employer has signed and notarized where required.
- Email the form: Send the completed Texas 5506 NAR form, along with any required documents, to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov.
Fulfilling these steps accurately ensures that your recertification process proceeds smoothly. After submission, keep an eye on your email for any notifications regarding your status or further documentation that may be required.
What You Should Know About This Form
What is the Texas 5506 Nar form used for?
The Texas 5506 Nar form is used for employment verification of Nurse Aides. It helps in confirming the employment status, along with ensuring that the aide meets certification and recertification requirements. This form must be completed and submitted to the Texas Nurse Aide Registry when a Nurse Aide is applying for recertification or needs to verify their credentials.
How do I complete the Texas 5506 Nar form?
To complete the form, the Nurse Aide must fill out Section 1 with personal information, including their name, mailing address, Social Security number, and certification details. It is crucial to read all instructions carefully before filling it out. Once completed, the form should be signed to verify the accuracy of the provided information. Section 2 must then be completed by the employer, who must also notarize their signature before the form is sent to the Texas Nurse Aide Registry.
Where do I send the completed Texas 5506 Nar form?
After completing both sections of the form, it should be emailed to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov. It is important to ensure that all required documents are included, as incomplete submissions may be returned without action.
What happens if I do not have all the required information or documents?
The Texas Nurse Aide Registry will return any requests that are incomplete or lacking necessary documentation. This emphasizes the importance of ensuring that all fields on the form are filled out accurately and completely. Additionally, proper documentation, such as in-service education certificates, should be available in case of an audit.
Can I verify my CNA certification status?
Yes, Nurse Aides can verify their Certified Nurse Aide (CNA) certification status online. By visiting the provided link, https://emr.dads.state.tx.us/DadsEMRWeb/, users can check their certification details directly. This feature helps maintain transparency regarding certification status and compliance with regulatory requirements.
What are the potential legal consequences of tampering with the Texas 5506 Nar form?
Tampering with or attempting to falsify a government record, such as the Texas 5506 Nar form, is a serious offense. It is classified as a third-degree felony, which may lead to a prison sentence of up to 10 years and a fine up to $10,000. It is crucial to provide truthful and accurate information when completing this form to avoid legal repercussions.
Common mistakes
Filling out the Texas 5506-NAR form can be a straightforward process, but several common mistakes can lead to complications. Understanding these errors is crucial for applicants seeking to avoid delays in their certification process.
One frequent mistake is leaving out essential information in Section 1. All fields must be filled out completely, including the name, mailing address, social security number, and contact details. Omitting even one piece of information can result in the form being returned without action, which can extend the timeline for your certification.
Another common error occurs when applicants fail to sign the form. The signature is a verification of the correctness of the information provided. Without this signature, the application is deemed incomplete. It is important to take a moment to ensure that all required sections are not only completed but also signed appropriately.
Some applicants neglect to verify their CNA certificate status before submitting the form. Using the provided link to check certification can help identify any issues in advance, which allows for timely corrections before applying. This proactive measure can save valuable time and prevent anxiety.
Section 2 of the form requires completion by the employer, and this part often contains errors. Employers may forget to notarize their signatures or provide necessary details, such as the dates of employment. Ensure that you communicate the requirements clearly to your employer to avoid delays due to incomplete information.
Misunderstanding questions regarding criminal history is also a concern. Applicants may either provide incorrect information regarding past convictions or fail to answer honestly. It is essential to complete this section with accuracy, as discrepancies can lead to disqualification from the registry.
The in-service education requirements must be addressed correctly. Many applicants mistakenly overlook mentioning whether they have completed the requisite 24 hours of education within the specified time frame. Being prepared to submit in-service certificates if contacted is also important, as this will corroborate your compliance with state regulations.
Lastly, failing to pay attention to submission instructions can cause frustration. Ensure that the completed form, along with all required documents, is emailed to the designated address. This step is crucial in maintaining communication with the Texas Nurse Aide Registry and ensuring that your application is processed smoothly.
Documents used along the form
When submitting the Texas 5506 Nurse Aide Registry Form, several other documents and forms may be required to ensure a complete application process. Each of these documents serves a specific purpose and helps streamline the verification of an applicant's qualifications. Understanding these additional forms can aid applicants in fulfilling their requirements efficiently.
- Employee Misconduct Registry Verification: This document verifies if the applicant is listed on the Employee Misconduct Registry (EMR). Being on this registry as unemployable may affect eligibility for certification.
- Criminal Background Check: While the Texas Nurse Aide Registry Form inquires about criminal convictions, a formal background check may be needed to provide a comprehensive view of an applicant's criminal history relevant to employment in healthcare.
- In-Service Education Certificates: Applicants must prove that they have completed 24 hours of in-service education within the past two years. Certificates from approved courses serve as documentation of compliance with this requirement.
- Notarized Employer Letter: If the employer is responsible for imprinting their official approval, this letter becomes necessary. It attests to the applicant's employment and confirms that they performed nursing-related services, which is part of the verification process.
By gathering these documents along with the Texas 5506 Nurse Aide Registry Form, applicants can ensure they meet all requirements for certification. This diligence can help avoid delays and foster a smoother transition into their roles as certified nurse aides.
Similar forms
- Employment Verification Form: Similar to the Texas 5506 Nar form, the Employment Verification Form also requires confirmation of employment history. Both documents collect information about the applicant’s previous roles and outline the responsibilities performed during employment. For both forms, an employer’s signature is needed to validate these claims.
- Professional License Application: Like the Nurse Aide Registry form, a professional license application typically requires personal information and proof of qualifications. Both documents often necessitate that applicants provide their employment details and may include sections for employer verification. The aim is to ensure that the applicant meets the necessary standards for certification or licensure.
- Background Check Authorization Form: This document shares characteristics with the 5506 Nar form as it requests information related to the applicant's background. Each requires consent from the applicant and confirms whether they have a clear record. Both forms are designed to assure compliance with professional standards and regulations.
- Continuing Education Requirement Form: Similar in function to the 5506 Nar form, this document verifies the completion of ongoing training or education. Both seek to confirm that individuals are maintaining their qualifications and staying updated on relevant professional practices, often requiring signatures from both the applicant and educational institutions to validate claims.
- Certification Renewal Application: Much like the Texas 5506 Nar form, this application facilitates the process of renewing certifications. It gathers essential information related to previous certifications, ongoing training, and personal details. Both documents ensure that individuals continue to meet the qualifications necessary to practice in their fields.
Dos and Don'ts
When filling out the Texas 5506 Nar form, it’s essential to follow certain guidelines to ensure a successful submission. Here’s a straightforward dos and don’ts list:
- Do: Complete all information in Section 1 accurately.
- Do: Obtain your employer’s verification in Section 2.
- Do: Ensure your employer’s signature is notarized.
- Do: Double-check your contact information for accuracy.
- Don't: Leave any sections of the form incomplete.
- Don't: Forget to sign and date your portion of the form.
- Don't: Submit the form without the necessary documents.
- Don't: Attempt to falsify any information, as this is a serious offense.
Misconceptions
There are many misconceptions about the Texas 5506 Nar form that can lead to confusion. Understanding these misconceptions can help ensure a smoother process for all involved. Below are nine common misconceptions along with explanations to clarify each point.
- Misconception 1: The form can be submitted without completing all sections.
- Misconception 2: Notarization of the employer’s signature is optional.
- Misconception 3: Once submitted, you do not have to worry about your submission being audited.
- Misconception 4: All criminal convictions disqualify you from recertification.
- Misconception 5: You can submit your application via mail only.
- Misconception 6: You need to complete the 24 hours of in-service education all at once.
- Misconception 7: The form is just a formality and does not require careful attention.
- Misconception 8: Only the applicant is responsible for ensuring the form is correct.
- Misconception 9: If your application is rejected, you cannot resubmit it.
It is essential to fill out all required information in Section 1 and to have Section 2 completed by your employer as well. Incomplete forms will be returned without action.
Notarization of the employer's signature in Section 2 is mandatory. Failure to notarize can result in delays or rejection of your submission.
In-service education requirements are subject to audit. You should keep records of your education and be prepared to submit certificates if contacted by the Texas Health and Human Services Commission (HHSC).
Only specific convictions listed in Texas Health and Safety Code, §250.006, impact your eligibility. It is vital to understand which offenses matter.
The Texas Nurse Aide Registry accepts email submissions. Be sure to email your completed form and any required documents to the provided email address.
It is not necessary to complete all 24 hours of education in one sitting. This requirement can be fulfilled over time within a two-year period.
This form is a critical document that requires careful attention. Failing to provide accurate information can have serious consequences, including penalties.
While the applicant must fill out their section accurately, the employer also has a crucial role in verifying and notarizing their section. Both parties must collaborate to ensure accuracy.
You can absolutely resubmit your application after addressing any deficiencies pointed out in the rejection. Ensure that all information is complete and accurate before resubmission.
Key takeaways
Filling out the Texas 5506 Nar form can be straightforward if you follow these key points:
- Complete All Sections: Ensure that all information in Section 1 is filled out accurately. Your signature verifies that the details provided are correct.
- Employer Verification: Section 2 must be filled out and notarized by your employer. This confirms your employment as a nurse aide.
- Submission Requirements: Email the completed form along with any required documents to the Texas Nurse Aide Registry at the specified email address. Incomplete submissions will not be processed.
- Stay Informed: You may verify your CNA certification status online. Additionally, keep an eye out for possible audits regarding in-service education requirements.
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