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Follow the steps below to complete your Massachusetts Nurse Aide Reciprocity Application. Ensure that you provide accurate information and have all necessary documents ready. Review each section carefully before submitting your application.

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How to fill out the Massachusetts Nurse Aide Reciprocity Application Instructions?

  1. 1

    Complete the Applicant Information and Current Registration sections.

  2. 2

    Send the application to the State Registry where you are currently certified.

  3. 3

    The Current State Registry will complete the Confirmation of State Registry section.

  4. 4

    The Current State Registry will either return the application to you or send it directly to the MA Reciprocity Program.

  5. 5

    Submit the completed application to the Massachusetts Reciprocity Program within 30 days of verification.

Who needs the Massachusetts Nurse Aide Reciprocity Application Instructions?

  1. 1

    Certified Nursing Assistants (CNAs) currently certified in another state who wish to work in Massachusetts.

  2. 2

    Nurse aides wanting to transfer their certification to the Massachusetts Nurse Aide Registry.

  3. 3

    Aides from specific states that do not process written verification for reciprocity.

  4. 4

    Individuals who need to verify their good standing on their current State Registry.

  5. 5

    Nurse aides required to complete the Confirmation by State Registry section.

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  1. 1

    Upload the Massachusetts Nurse Aide Reciprocity Application to PrintFriendly's PDF editor.

  2. 2

    Fill out the required sections with accurate information.

  3. 3

    Double-check each section for completeness and accuracy.

  4. 4

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  5. 5

    Save and download the edited PDF once you are satisfied with your changes.

What are the instructions for submitting this form?

To submit the Massachusetts Nurse Aide Reciprocity Application, complete the form and send it to the Nurse Aide Registry of the state where you are currently certified. Once verified, either mail the original completed application to Prometric, MA Nurse Aide, 7941 Corporate Drive, Nottingham, MD 21236, or have your current state registry send it directly. Ensure the completed applications are submitted within 30 days of verification. For any assistance, contact Prometric staff at MACNA@prometric.com or 1-800-722-2594. My advice is to ensure all steps are followed accurately and promptly to avoid delays.

What are the important dates for this form in 2024 and 2025?

Submit your completed Massachusetts Nurse Aide Reciprocity Application within 30 days of verification from your current state's Nurse Aide Registry.

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What is the purpose of this form?

The Massachusetts Nurse Aide Reciprocity Application is designed for certified nursing assistants (CNAs) who are currently certified in another state and wish to work in Massachusetts. This form helps streamline the process of transferring your certification to the Massachusetts Nurse Aide Registry. By completing this application accurately and timely, you can ensure a smooth transition and continue your practice in Massachusetts.

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Tell me about this form and its components and fields line-by-line.

This form contains several sections that need to be filled out accurately. Below are the components/fields along with their descriptions:
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  • 1. Last Name: Your legal last name as it appears on your current certification.
  • 2. First Name: Your legal first name as it appears on your current certification.
  • 3. Middle Initial: Your middle initial, if applicable.
  • 4. Street Address: Your current street address where you reside.
  • 5. City: The city you reside in.
  • 6. State: The state you reside in.
  • 7. Zip Code: Your current zip code.
  • 8. Social Security Number: Your social security number.
  • 9. Date of Birth: Your date of birth.
  • 10. Daytime Phone Number (with Area Code): Your daytime phone number, including the area code.
  • 11. Email Address: Your current email address.
  • 12. State in which you are currently registered: The name of the state where you are currently certified as a nursing assistant.
  • 13. Current Registration Number: Your current certification or registration number.
  • 14. Expiration Date: The expiration date of your current certification.
  • 15. Candidate Signature: Your signature, certifying the accuracy of the information provided.
  • 16. Date: The date you signed the application.
  • 17. Verification by Current State Registry: Section to be completed by the state registry where you are currently certified.
  • 18. Confirmation of State Registry: Confirms your status, including your standing and any findings of abuse or neglect.
  • 19. Verifying Agency/Current State Registry Name: The name of the agency verifying your current certification.
  • 20. Title: Title of the authorized registry representative.
  • 21. Authorized Signature of Current State Registry: Signature of the authorized registry representative.
  • 22. Date: The date the registry representative signed the application.

What happens if I fail to submit this form?

If you fail to submit the Massachusetts Nurse Aide Reciprocity Application, you will not be able to transfer your certification to Massachusetts. This may result in delays or inability to work as a certified nursing assistant in the state.

  • Delay in Certification: Your certification transfer will be delayed, affecting your ability to work.
  • Inability to Work in Massachusetts: Failure to submit the form prevents you from being certified in Massachusetts.
  • Missed Deadlines: You may miss important deadlines, requiring re-submission and additional verification.

How do I know when to use this form?

Use this form when you are a certified nursing assistant in another state and wish to work in Massachusetts. Follow the outlined steps to transfer your certification.
fields
  • 1. Transfer Certification: To transfer your current nursing assistant certification to Massachusetts.
  • 2. Verify Good Standing: To verify your good standing on the current state's Nurse Aide Registry.
  • 3. Confirm Certification: To confirm your certification details with the Massachusetts Nurse Aide Registry.
  • 4. Renew Certification: To renew your nursing assistant certification by transferring it to a new state.
  • 5. Employment Opportunity: To seek employment as a certified nursing assistant in Massachusetts.

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Upload the PDF to PrintFriendly, fill out the required information, review each section for accuracy, and save the completed form.

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Use PrintFriendly's sharing options to email the completed PDF or download it for personal use.

What information do I need to fill out the Massachusetts Nurse Aide Reciprocity Application?

You need your personal information, current registration details, and confirmation from your current State Registry.

Is there a deadline for submitting the Massachusetts Nurse Aide Reciprocity Application?

Yes, the completed application must be submitted to the Massachusetts Reciprocity Program within 30 days of verification from your current state's Nurse Aide Registry.

Can I edit the Massachusetts Nurse Aide Reciprocity Application after I've filled it out?

Yes, you can make further edits using PrintFriendly's PDF editor before saving the final version.

What should I do if I need help filling out the Massachusetts Nurse Aide Reciprocity Application?

Contact Prometric staff at MACNA@prometric.com or call 1-800-722-2594 for assistance.

How long does it take to receive the Massachusetts Certificate and Wallet Card?

You should receive the Massachusetts Certificate and Wallet Card within 15 days of Prometric receiving the completed application.

Do all states process the Massachusetts Nurse Aide Reciprocity Application the same way?

No, certain states like California, Louisiana, and others require Prometric to process the verification instead of the state registry.

Who needs to complete the Massachusetts Nurse Aide Reciprocity Application?

Certified nursing assistants currently certified in another state who wish to work in Massachusetts must complete this application.

Massachusetts Nurse Aide Reciprocity Application Instructions

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