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AR CNA Reciprocity 9110AR - $25.00

Arkansas Reciprocity Form (For placement on the Arkansas Nurse Aide Registry via Interstate Transfer Form supplemental to form DMS-798 [R. 2/2015])

Reciprocity Student
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Nursing Student or RN Candidate Examination

Nursing Student or RN Candidate Examination Application in order to qualify to take the state of Arkansas nurse aide competency exam.

Waiver Student
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Out-of-State Training Waiver

Waiver Student
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NURSE AIDE: Nurse Aide Instructor Login Request Form

This form is for DHS-approved Nurse Aide Instructors in Arkansas who would like to request access to TMU.

Instructor
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NURSE AIDE: RN Test Observer | Test Administration Services Entity (TASE) Application - $100.00

Application to be certified as an RN Test Observer/Test Administration Services Entity (TASE) for Nurse Aide Competency Exam testing services in the state of Arkansas.

Observer
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Actor Training Affidavit and Confidentiality/Nondisclosure Agreement

Application to be certified as an Actor for Arkansas nurse aide competency testing.

Actor
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Knowledge Test Proctor (KTP) Training Affidavit and Confidentiality/Nondisclosure Agreement

Application to be certified as a Knowledge Test Proctor (KTP) for Arkansas nurse aide competency testing.

Proctor
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RENEWAL VIA OUT-OF-STATE EMPLOYMENT - $25.00

Complete this form for out-of-state work hours to qualify for renewal on the Arkansas nurse aide registry.

Recertification By Renewal
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DEMOGRAPHIC CHANGE/CORRECTION REQUEST FORM

This form is to update, change or correct the spelling of your name or update/correct your social security number in your TMU© account.

Waiver Student
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LETTER OF INTENT

Employment Verification for Funding

Waiver Student
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TEST REVIEW REQUEST AND PAYMENT FORM - $25.00

This application is to request a review of your test results or dispute any other condition of your testing that you think altered the outcome of your test. You must submit the $25 non-refundable test review fee and a detailed explanation with this Test Review Request. We recommend calling D&SDT-HEADMASTER staff for a test results consultation before submitting this form with your test review fee. NOTE: Please refer to the Candidate Handbook ‘Test Review Requests’ section.

Waiver Student
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