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Nurse Aide Registry Applications and Forms

How to Ensure Your Certification Is Processed Timely
Legal Resident Affidavit Forms
Recertification Application for Nurse Aides

Duplicate or Amended Nurse Aide Card

Reciprocity Application Form

Notification Forms

Approved Nurse Aide Training and Competency Evaluation Programs

Contact Information

NOTE: Applications on this page have been converted to PDF files. You will need the Adobe™ Acrobat ™ Reader to view the files.  A short-cut is provided on the left in the blue column. 

  IMPORTANT REQUIREMENTS FOR RENEWAL!  The Oklahoma Taxpayer and Citizen Protection Act of 2007 requires anyone seeking a license, permit, or certificate to complete an affidavit of legal residence. One of the legal resident affidavit forms, linked below, must be completed and submitted to the Nurse Aide Registry with each nurse aide certification and/or recertification application. The relevant portion of the law may be found at Title 21 O.S. Section 1550.42.

Legal Resident Affidavit Forms

Affidavit of Lawful Presence Directions and Information

 Affidavit of Lawful Presence of Person Making Application for a License, Permit, or Certification

 Affidavit of Lawful Presence by Guardian of Person Making Application for a License, Permit or Certification

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Recertification Application

How to Ensure Your Certification Is Processed Timely

Recertification Application ODH Form 717 (395k, PDF)

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Please contact Kathryn Waller, Health Facilities Surveyor, for Nurse Aide Training and Competency Evaluation Program applications at: (405) 271-9444 ext 50151 or toll free 800-695-2157 or e-mail kathrynew@health.ok.gov.

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Notification Forms

    Notification of Nurse Aide Abuse, Neglect, Mistreatment or Misappropriation of Property

   ODH Form 718 (9K) 

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Contact Information
Nurse Aide Registry

1000 N.E. 10th Street, Room 1111
Oklahoma City, OK  73117
Phone (405) 271-4085 or toll free 800-695-2157
E-Mail  nar@health.ok.gov


Frequently Asked Questions
Q: May I fax or e-mail my application to the Nurse Aide Registry?
A: The Registry requests that all applications be mailed to the address on the top of the form, or dropped off on the 1st floor of the Oklahoma State Department of Health in Oklahoma City.

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