[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458432-105":59,"doc-detail-458432-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","uniform-employment-application-for-nurse-aide-staff","Uniform Employment Application for Nurse Aide Staff","","Uniform Employment Application for Nurse Aide Staff used for employment in nursing and specialized nursing facilities, residential care homes, assisted living centers, continuum of care facilities, hospice programs, adult day care centers, and home care agencies. The form collects applicant identification and contact details, desired position and availability, U.S. military discharge record, prior employment history for the last four jobs plus other employers for five years, education credentials, and nurse aide certification details such as CNA-related designations and CMA subtypes, including continuing education confirmation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/uniform-employment-application-for-nurse-aide-staff/458432/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/uniform-employment-application-for-nurse-aide-staff/458432.png","ImageObject",300,407,{"name":92,"@type":93},"Maya Linwood","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Who is required to use this uniform employment application?","Question",{"text":113,"@type":114},"The form is required for employment of nurse aides in nursing and specialized nursing facilities and several related care settings, including residential care homes, assisted living centers, hospice programs, adult day care centers, and home care agencies.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What personal details and contact information does the application request?",{"text":118,"@type":114},"It requests date of application and availability date, applicant name and social security number, emergency contact, present and permanent addresses, telephone number, date of birth, and sex and race information.",{"name":120,"@type":111,"acceptedAnswer":121},"What sections cover work history, education, and certifications?",{"text":122,"@type":114},"Work history is covered under Prior Work History (including the last four jobs and other employers for the last five years). Education is covered under Educational Background, and nurse aide certifications (including CNA designations and CMA-related certifications) are covered under Certification, along with continuing education confirmation for current periods.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},458432,1790800842,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962084928432,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","# Uniform Employment Applicationfor Nurse Aide Staff\n\nThis application form is required by Title 63 O.S.§1-1950.4 of state law and by the Oklahoma State Board of HealthRules OAC 310-2-15-3.This uniform application shall be used as the only application for employment of nurse aides innursing and specialized nursing facilities,residential care homes,assisted living centers,continuum of care facilities,hospice programs,adult day care centers and home care agencies.  \nThis employer does not discriminate in its hiring decisions or in any other employment decision on the basis of race,color,sex,religion,citizenship,national origin,veteran status,age or upon a physical or mental disability which isunrelated to the applicant's/employee's ability to perform the essential functions of the position.  \n## ATTENTION NURSE AIDES:RETURN YOUR COMPLETED APPLICATION TO EMPLOYER.\n\nDate of Application:        Date Available to Start Work:          Name:                                                                                      Social Security Number:          (Last)(First)(Middle)List any other name(s)you have previously worked under,such as maiden name:                                           Emergency Contact Person:ame)  \n## 1.   Personal Information\n\n\n| Present Address:   |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- |\n| Srcet)   |  | (City)   |  | (State)   | (Zip)   |\n| Permanent Address (if different than present adress):   |  |  |  |  |  |\n|  |  |  |  |  |  |\n|  |  |  | (City)   | (State)   | (Zip)   |\n| Telephone\\#:___         | ___Date of Birth:   | ______   | ___Sex:__M___F Race:__   |  |  |\n|  |  | -----------or purposes of Criminal History Rec   |  | ords Search -   | ---------   |\n\n(Address)(Phone Number)—  \n## 2.  Employment Desired\n\nPosition applied for:  \n                               Salary required:           \nHours available to work:      \nDays        \nWeekends  \nEvenings        \nNights        \nWill you accept employment of:        \nFull Time?          \nPart Time?        \nOccasional Part Time?  \n## 3.  U.S.Military Record\n\nType of Discharge:________  _  \nBranch:                            \nDate Entered:                \nDate Discharged:            \n## 4.  Prior Work History List your last four(4)jobs beginning with your most recent or current employer.\n\nEmployer's Name:                                                        \nTelephone Number:          \nEmployer's Address:                                                                                            \n(State)    (Zip)  \n(City)  \nPosition Held:                                    \nSupervisor:                                                    \nDates Employed:From(month/year)         \nSalary:             \nTo(month/year)          \nReason for Leaving:                                                                                            \nOklahoma State Department of HealthProtective Health Services  \nUnifom Employment Application for Nurse Aide Staff  \nEmployer's Name                           ___________Telephone Number:                Employer's Address:  \n(Street)  \n(City)(State)(Zip)Position Held:               Supervisor:                            Dates Employed:From(month/year)              To(month/year)                  Salary:                        Reason for Leaving:                             Employer's Name:                           Telephone Number:        Employer's Address:                                                                                                \n(City)      —(State)(Zip)Position Held:                                  Supervisor:                          Dates Employed:From(month/year)              To(month/year)        Salary:                    Reason for Leaving:                              Employer's Name                             Telephone Number:                Employer's Address:                                                                                      \n(Street)(City)(State)(Zip)Position","cbCaisOqLnzcpk65","https://ap.wps.com/l/cbCaisOqLnzcpk65","pdf",627762,"English","# Uniform Employment Application for Nurse Aide Staff\n## Attention Nurse Aides\n## 1. Personal Information\n## 2. Employment Desired\n## 3. U.S. Military Record\n## 4. Prior Work History\n## 5. Educational Background\n## 6. Certification","[{\"question\":\"Who is required to use this uniform employment application?\",\"answer\":\"The form is required for employment of nurse aides in nursing and specialized nursing facilities and several related care settings, including residential care homes, assisted living centers, hospice programs, adult day care centers, and home care agencies.\"},{\"question\":\"What personal details and contact information does the application request?\",\"answer\":\"It requests date of application and availability date, applicant name and social security number, emergency contact, present and permanent addresses, telephone number, date of birth, and sex and race information.\"},{\"question\":\"What sections cover work history, education, and certifications?\",\"answer\":\"Work history is covered under Prior Work History (including the last four jobs and other employers for the last five years). Education is covered under Educational Background, and nurse aide certifications (including CNA designations and CMA-related certifications) are covered under Certification, along with continuing education confirmation for current periods.\"}]","Uniform Employment Application for Nurse Aide Staff | PDF",1790753042,25]