Medication Aide Renewal Form

Overview

Welcome!  This form is designed to renew your MEDICATION AIDE LONG-TERM CARE facility registration only.
This form DOES NOT renew your nurse aide registration. This form DOES NOT renew your medication aide registration for adult care facilities.

* Denotes required fields

Registry Search

First Name:   *
Last Name:   *
Last 4 Digits of Social Security Number:   *
Date of Birth:   *
Medication Aide Listing Number (6 digits): 
(This is not your nurse aide listing number)
Click here to find the medication aide listing number. 
M  *             Click the Submit button to proceed.

Message:

 
Registration/Listing Period:                Registration Expiration Date:   


DHSR Medication Aid Registry Website

v 1.09, 09/02/21