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Click ‘Get Form’ to open the Iowa Direct Care Worker Registry Application in the editor.
Begin with Section 1, where you will fill in your personal details such as Social Security Number, Date of Birth, and contact information. Ensure all fields are completed accurately.
If you are transferring from another state, indicate this in the 'State Certified (if other than IA)' field and provide your license number and expiration date.
Complete the Employment History section by listing your previous employers in chronological order, starting with the most recent. Include hire and separation dates where applicable.
Move to Section 2, which must be filled out by your hiring entity. They should provide their details and sign the affidavit confirming your employment.
Once all sections are complete, review for accuracy before submitting. You can easily save or print the form directly from our platform.
Start filling out your Iowa CNA Registry application today for free using our editor!
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