[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-306318-105":53,"doc-detail-306318-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","new-york-state-nurse-aide-registry-renewal-form","New York State Nurse Aide Registry Renewal Form","","New York State Nurse Aide Registry Renewal instructions and form for recertification. Certified nurse aides renew eligibility by confirming at least seven paid hours as a nurse aide within the previous 24 months in eligible Article 28 health care facilities. The form collects nurse aide identity, address, contact details, prior name documentation, employment or staffing agency information, and director verification. Required fields marked with an asterisk must be completed; missing or illegible submissions may be rejected. Payment of a $40 fee via certified check, money order, or voucher is submitted to Prometric.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/new-york-state-nurse-aide-registry-renewal-form/306318/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/new-york-state-nurse-aide-registry-renewal-form/306318.png","ImageObject",442,249,{"name":88,"@type":89},"Sophia Brooks","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-28","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":15},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What are the eligibility requirements to renew a New York Nurse Aide Registry certification?","Question",{"text":108,"@type":109},"Eligibility requires working as a healthcare nurse aide for at least 7 hours within the previous 24-month period before the certification expiration date in a qualifying Article 28 health care facility.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"When is renewal not eligible?",{"text":113,"@type":109},"Renewal is not eligible for nurse aides with registry employment restrictions related to resident abuse, neglect, misappropriation of resident property, or criminal record disqualifications.",{"name":115,"@type":106,"acceptedAnswer":116},"What payment methods are accepted and where should the form be mailed?",{"text":117,"@type":109},"The form requires a $40 payment sent to Prometric by certified check, money order, or voucher/purchase order. Personal checks and cash are not accepted, and completed forms must be mailed to the Prometric address listed in the document.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},306318,1790438158,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":15,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":47,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":73},962084925636,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","New York State  \nNurse Aide Registry Renewal  \nInstructions:  \n• [Please go to](Please go to www.prometric.com/NurseAide/NY to)[ ](Please go to www.prometric.com/NurseAide/NY to)[www.prometric.com/NurseAide/NY](Please go to www.prometric.com/NurseAide/NY to)[ to](Please go to www.prometric.com/NurseAide/NY to) print the current version of this application. DO NOT submit photocopies of this application as this may impact the ability to process the application. Incomplete, blurred, or illegible applications will not be processed.  \n• Please complete all the information requested on this application, including the employer information. Failure to fully complete all pages may result in delays or denial of the renewal of the certification.  \n• Please mail the completed application and $40 payment to:  \nPrometric  \n6211 Greenleigh Avenue, Suite 400  \nMiddle River, MD 21220  \nATTN: NY Nurse Aide Registry Renewal  \n*If the nurse aides legal name has changed after the last time they were certified, provide a copy of acceptable legal documentation such as a marriage certificate; divorce decree; birth certificate; and/or court documents, along with this application.  \nEligibility for Renewal  \nA Certified Nurse Aide is eligible to recertify if they have worked as a healthcare nurse aide for at least 7 hours within the previous 24-month period prior to their certification expiration date in a health care facility. Health Care Facilities are defined as Health Care Facilities licensed under Article 28 of NYS Public Health Law.  \nNurse Aides with employment restrictions on the registry for resident abuse, neglect, misappropriation of resident property or criminal record disqualifications are not eligible for renewal.  \nImportant Note: All fields marked with * are required. Form will not be processed without all required information.  \nNew York State  \nNurse Aide Registry Renewal  \nAll fields marked with * are required.  \nNURSE AIDE INFORMATION  \n\n|  |  |\n| --- | --- |\n| * NYS Nurse Aide Certification \\# * Date of Birth mm/dd/yyyy |  |\n| * First Name\u003Cbr>* Last Name | MI\u003Cbr>Previous Name (if applicable)\u003Cbr>Must include verifying documentation* |\n| *Street Address (including Apt. number or P.O. Box) ☐ This is an updated address. |  |\n| *City *State *Zip Code *County\u003Cbr>( )  -   \u003Cbr>* Daytime Phone Number * Email Address (Form will not be processed without an email address)\u003Cbr>EMPLOYMENT INFORMATION (current or previous employer) |  |\n| Article 28 Facilities ONLY |  |\n\n*Contact Name  \n*Article 28 Facility Type (choose one)☐ Nursing Home  \n☐ Hospital  \n☐ D&TC Type  \n| * Name of Employer |\n| --- |\n| *Street Address |\n\n*City *State *Zip Code  \n*Provide Dates of Employment as a Nurse Aide:   From (mm/dd/yyyy) To (mm/dd/yyyy)  \n*Is the Nurse Aide currently employed at this facility? ☐ Yes ☐ No  \nNew York State  \nNurse Aide Registry Renewal  \nStaffing/Employment Agencies ONLY  \n*Staffing Agency Contact  \n* Name of Staffing Agency  \n*Article 28 Contractor Name  \n* E-mail (form will not be processed without this)  \n33- * Employer Code  \n* PFI or Operating Certificate \\#  \n* Date(s) of Assignment as a Nurse Aide:  \nFrom (mm/dd/yyyy) To (mm/dd/yyyy)  \n______________________________ ____________________  \n* Employment Agency Signature * Date  \nNew York State  \nNurse Aide Registry Renewal  \n\n| Certification\u003Cbr>I certify the individual named herein has worked for pay as a nurse aide, under the supervision of a registered nurse, at the Article 28 Facility listed below, for at least seven hours within the previous 24-month period pursuant to 10 NYCRR 415 . 26(d)(6) .\u003Cbr>I certify to the best of my knowledge that the information put forth on this New York State Nurse Aide Registry Recertification Form is true and correct. |  |\n| --- | --- |\n| * Director of Nursing/Designee (Article 28 Facility)\u003Cbr>* Name of Article 28 Facility | *Title\u003Cbr>* E-mail address (Form will not be processed without this) |\n| *Signature * Date |  |\n\nPlease Note: If the recertification i","cbCaiuBXMqbgMHuX","https://ap.wps.com/l/cbCaiuBXMqbgMHuX","pdf",231562,"English","# Instructions\n# Eligibility for Renewal\n# Nurse Aide Information\n# Employment Information\n# Staffing/Employment Agencies\n# Certification\n# Payment Form","[{\"question\":\"What are the eligibility requirements to renew a New York Nurse Aide Registry certification?\",\"answer\":\"Eligibility requires working as a healthcare nurse aide for at least 7 hours within the previous 24-month period before the certification expiration date in a qualifying Article 28 health care facility.\"},{\"question\":\"When is renewal not eligible?\",\"answer\":\"Renewal is not eligible for nurse aides with registry employment restrictions related to resident abuse, neglect, misappropriation of resident property, or criminal record disqualifications.\"},{\"question\":\"What payment methods are accepted and where should the form be mailed?\",\"answer\":\"The form requires a $40 payment sent to Prometric by certified check, money order, or voucher/purchase order. Personal checks and cash are not accepted, and completed forms must be mailed to the Prometric address listed in the document.\"}]","New York State Nurse Aide Registry Renewal Form | PDF",1789835381]