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Nursing inservice template 2025

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The document is a form for recording inservice education for nurse aides in New Mexico, detailing the categories of training provided, such as resident rights, safety, nutrition, and infection control. It requires specific information about the facility, attendees, and certification details, along with a signature from the instructor. The form must be submitted to Prometric within two weeks.

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Click ‘Get Form’ to open the nursing inservice template in the editor.
Begin by entering the 'Date of Inservice' at the top of the form. This is crucial for record-keeping.
Fill in the 'Title' of the inservice program, followed by the 'Facility Offering Inservice' and its address details including city, state, and ZIP code.
Input your 'License #' and ensure you provide your 'Social Security Number' as this is mandatory for processing.
In the 'CATEGORY' section, select appropriate categories from A to J that correspond to the topics covered during the inservice. Record hours spent on each category accurately.
Complete the section for 'NAME OF NURSE AIDE ATTENDING INSERVICE EDUCATION PROGRAM' and their corresponding certificate number.
Finally, have an authorized person sign off on the form, including their printed name and title before submission.

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