Out-of-State Nurse Aide Application to Become - Illinois Department ... 2026

1. Click ‘Get Form’ to open the Out-of-State Nurse Aide Application in the editor.
2. Begin by entering today's date and your full name, including first, middle, and last names. Ensure that all information is typed or printed legibly.
3. Fill in your address details accurately, including street, apartment number (if applicable), city, state, and ZIP code.
4. Provide your telephone number and Social Security Number as required. This information is crucial for processing your application.
5. Indicate the states where you have been certified as a CNA and include any previous names if applicable. Attach legal documents for name changes if necessary.
6. Complete the personal identification section by providing details such as sex, race, height, weight, date of birth, hair color, eye color, and place of birth.
7. Answer questions regarding any administrative findings of abuse or criminal offenses honestly. If applicable, provide detailed explanations in the space provided.
8. Review all entered information for accuracy before signing and dating the application at the bottom.
9. Once completed, mail the form to the Illinois Department of Public Health at the specified address. Ensure you keep a copy for your records.

Start using our platform today to streamline your application process for free!