Nursing Assistant Registry Forms

From this page you may download form(s) to update your information on the Minnesota Nursing Assistant Registry, or to have your records transferred to the Minnesota Registry from another state.  There is NO PROCESSING FEE for the Minnesota Registry.

To view and print the PDF files listed in these documents you will need to download Adobe Acrobat Reader or Adobe Acrobat Reader for Visually Imaired Readers. Adobe provides a free download for these applications at their website.

Nursing Assistant Registry Update Forms

Complete the Nursing Assistant Registry Update Form if you are currently on the Registry and need to change or add information to your file.
 Nursing Assistant Registry Update Form (pdf: 1 page/27kb).

Interstate Endorsement Forms

Complete the Interstate Endorsement Forms if you wish to transfer your certificate to the Minnesota Nursing Assistant Registry from another state. Please read and follow the directions on the form(s) carefully. Incomplete forms will delay your transfer to the Minnesota Registry and will be returned to you.

 Interstate Endorsement Forms.

Interstate Endorsement Forms can now be submitted electronically. Please Note: Only Interstate Endorsement Forms will be processed from this site.
 Instructions to Upload Files for Interstate Endorsement to NA Registry

If you need additional help completing these forms, please contact the Nursing Assistant Registry by telephone or in writing:

Between the hours of 9:00a.m. and 3:00p.m., Monday thru Friday.
Telephone: (651) 215-8705
Toll Free, Greater Minnesota 1-800-397-6124

Nursing Assistant Registry
P.O. Box 64501
St. Paul, Minnesota 55164-0501

You may also contact the Nursing Assistant Registry by Email at: health.FPC-NAR@state.mn.us

Updated Tuesday, 16-Apr-2013 11:14:45 CDT