The Texas Nurse Aide Registry 5505-NAR form is a crucial document used for the registration and verification of nurse aides in Texas. This form helps ensure that individuals meet the necessary qualifications to provide care in various healthcare settings. Understanding its purpose and the process involved can greatly benefit those seeking to work as nurse aides in the state.
The Texas Nurse Aide Registry 5505-NAR form plays a crucial role in the certification and registration of nurse aides in Texas. This form serves as a comprehensive application that individuals must complete to demonstrate their qualifications and eligibility to work in various healthcare settings. It encompasses essential information such as personal details, educational background, and training history, ensuring that only those who meet the state's standards can provide care to patients. Additionally, the form includes sections for background checks, which are vital for maintaining the safety and integrity of healthcare environments. By submitting the 5505-NAR form, applicants not only affirm their commitment to the profession but also contribute to the overall quality of care in Texas. Understanding the nuances of this form is essential for aspiring nurse aides and employers alike, as it lays the foundation for a career in this rewarding field.
Texas Nurse Aide Registry
Form 5505-NAR
December 2022-E
Request for Entry on the Texas Nurse Aide Registry Through Reciprocity
Applicant Information (To be completed by applicant.)
Note: You are not eligible to be employed as a nurse aide in the state of Texas until your request has been approved and you have been entered into the registry.
Read the following instructions before completing this form.
•Complete all information in Section 1. Your signature is required at the bottom of Section 1 to verify that information you provided is correct.
•Once Section 1 is complete, email this form, a legible copy of a government issued identification that shows your birth date and the correct spelling of your name, copy of your Social Security card, and your Texas criminal history results for all legal last names you ever had from the Texas Department of Public Safety at publicsite.dps.texas.gov/ConvictionNameSearch to: nurseaideregistry@hhs.texas.gov (See back of form for more instructions.)
•If you do not have an expiration date in the state you are active in, you must also complete and submit Form 5506-NAR, Employment Verification. The form must be completed by your most recent employer (within the last two years).
Name (Last, First, Middle):
Maiden Name (if applicable):
Social Security No.:
Sex:
Date of Birth:
Email Address:
Male
Female
Mailing Address (Street or P.O. Box):
City:
State:
ZIP Code:
Phone No.:
State(s) Where Issued:
Nurse Aide Certificate No.(s)
Issue Date(s):
Signature – Applicant
Date
You must submit the following items:
Completed Form 5505-NAR – Signed and dated
Copy of your government issued current photo ID
Copy of your Social Security card
Texas Department of Public Safety criminal history check for all legal last names ever had (either Fingerprint Cards with results or Name Based completed online for all last names ever used)
Email the completed form and required documents to the Texas Nurse Aide Registry at nurseaideregistry@hhs.texas.gov.
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Address:
Instructions
Nurse Aides who are listed active on a registry in another state and are requesting to be placed on the Texas Nurse Aide Registry by reciprocity must meet eligibility requirements listed, per Texas Standards for Nurse Aides, Section twenty six26 TAC 556.11(b)(1-5). No person listed as unemployable on the Employee Misconduct Registry (EMR) or who has been found to have a conviction of a criminal offense listed in Texas Health and Safety Code, Section250.006, will be eligible for reciprocity. Find Chapter 250 and for list of convictions at statutes.legis.state.tx.us\Docs\HS\htm\HS.250.htm#00.
Nurse Aide Registry staff will complete the EMR check.
The person requesting reciprocity must obtain a criminal history check from the Texas Department of Public Safety (DPS). For instructions on how a person can obtain a named-based criminal history check for all names ever used, visit publicsite.dps.texas.gov/ConvictionNameSearch.
You must submit your criminal history results along with the reciprocity Form 5505-NAR to be placed on the Texas Nurse Aide Registry by reciprocity.
Applicant, did you:
•Sign the form?
•Include your criminal history results for all last names you ever had, a legible photocopy of your state issued picture identification showing your birth date and correct spelling of your name, and a copy of your Social Security card?
Did you know?
•You can verify certificate status by using the following link: emr.dads.state.tx.us/DadsEMRWeb/
•You can download forms from our website: hhs.texas.gov/doing-business-hhs/licensing-credentialing-regulation/credentialing/nurse-aide- registry/nar-forms
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 call the Nurse Aide Registry at 512-438-2050.
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