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NURSE AIDE: Nurse Aide Instructor Login Request Form Application

Please complete this form if you are a Arkansas Department of Health (DHS)-approved Instructor in a Nurse Aide Training Program in Arkansas and would like to access TMU.   

NOTE:  If you are an instructor for multiple training programs, please list the programs and upload your documentation under the Nurse Aide Training Program Affiliation section.

Once you have completed all of the fields and uploaded the required documents within this application, select “Send Application" to submit your application.
Address
RN License Information
Nurse Aide Training Program Affiliation
Affidavit
  • I have uploaded my documentation showing that I am a DHS-approved nurse aide Instructor.
  • If I am an instructor for multiple programs, I have listed those programs and uploaded my documentation showing that I am a DHS-approved nurse aide Instructor.
By Submitting
I hereby verify that I understand and agree with the statements contained herein and the above information is true and correct.