How to Fill Out and Submit the Prometric Nurse Aide Renewal Form

To renew your CNA certification through Prometric, download your state’s Prometric nurse aide renewal form, fill in your personal information, have an authorized supervisor at your workplace complete and sign the employment verification section, and mail the form with payment to Prometric’s processing center in Middle River, Maryland. The form, the fee, and the exact signature rules depend on which state issued your certification, so start by pulling the PDF labeled for your state.

Confirm Your State Uses Prometric

As of 2026, Prometric manages the nurse aide registry for Connecticut, Delaware, Hawaii, Idaho, Michigan, New Mexico, and New York.1Prometric. Registry Services If you’re certified in one of those states, you’ll use a Prometric renewal form. If you’re not, your registry is run by a different vendor or by the state health department, and the Prometric form is the wrong one.

Each Prometric state publishes its own PDF. Hawaii’s is the “Hawaii Nurse Aide Registry Recertification Form”; New Mexico’s is the “New Mexico Nursing Assistant Registry Renewal Form.”2Prometric. Hawaii Nurse Aide Registry Recertification Form3Prometric. New Mexico Nursing Assistant Registry Renewal Form Download the one for your state from prometric.com. Print it, and fill it out by hand unless the PDF is fillable.

Before You Start: Do You Qualify to Renew?

The federal rule behind every state renewal is 42 CFR 483.156, which directs states to remove any nurse aide who has performed no nursing or nursing-related services for 24 consecutive months.4eCFR. 42 CFR 483.156 – Registry of Nurse Aides Most Prometric-managed states apply this as a minimum of eight hours of paid, supervised nursing work during the two-year renewal window.5Georgia Nurse Aide Registry. Georgia Nurse Aide Registry – Nurse Aide Certification Renewal

Volunteer time doesn’t count. Orientation, training, and in-service hours don’t count either; only regular compensated CNA shifts qualify, and some states ask for a pay stub as proof.6Minnesota Department of Health. Nurse Aide Registry Tutorial – Submitting Your Renewal Application

Your registry entry also has to be in good standing. A documented finding of abuse, neglect, or misappropriation of a resident’s property will block the renewal.4eCFR. 42 CFR 483.156 – Registry of Nurse Aides

One edge case worth flagging: private-duty work hired directly by a patient or family usually doesn’t meet the supervision requirement, because the hours have to be delegated and supervised by a registered nurse.7N.C. Department of Health and Human Services. Nurse Aide I Employment Verification by a Registered Nurse Working for a licensed home health agency that assigns you to a patient’s home typically does qualify, because the agency provides the RN oversight and the records.

Section 1: Your Personal Information

The top portion of the form asks for your full legal name, any former or maiden names, mailing address, phone, and email. States differ on identifiers: Hawaii asks for your Social Security number and date of birth, while New Mexico wants your certification number.2Prometric. Hawaii Nurse Aide Registry Recertification Form3Prometric. New Mexico Nursing Assistant Registry Renewal Form

The name you write has to match the name on your registry listing exactly. If you’ve legally changed your name since your last renewal, submit a separate name-change request with supporting documents (marriage certificate, court order, or amended Social Security card) before or alongside the renewal. A mismatch is one of the most common reasons packets get bounced.

Section 2: Employment Verification

This is the half of the form you cannot complete yourself. Someone at your workplace who can verify your employment from facility records has to fill it out and sign it. Depending on the state, that signer may be a registered nurse who supervised you, the facility administrator or director, or a human resources official.3Prometric. New Mexico Nursing Assistant Registry Renewal Form In New Mexico, both the administrator and the supervising nurse must sign if the facility is not Medicaid-approved.

The verification section typically asks for:

  • Facility name and license number (state license, Medicare/Medicaid provider number, or equivalent)
  • Your hire date and, if you’ve left, your last date of employment
  • Facility address and phone for audit purposes
  • The signer’s printed name, title or credential, signature, and date

The signing RN has to be able to back the claim up with written documentation or facility records if audited.7N.C. Department of Health and Human Services. Nurse Aide I Employment Verification by a Registered Nurse If your former facility has closed and no supervisor can sign, don’t guess — call your state registry office. A coordinator may accept alternative documentation in hardship situations, but only if you arrange it in advance.

Fee and Payment

Fees are non-refundable and vary by state. Hawaii charges $27, New Mexico charges $26.25 (tax included), and New York is around $40.2Prometric. Hawaii Nurse Aide Registry Recertification Form3Prometric. New Mexico Nursing Assistant Registry Renewal Form Your form will list the exact amount.

Personal checks and cash are generally not accepted. Most forms specify money orders, cashier’s checks, or credit card payment through the authorization section on the form itself. If you pay by card, complete the full block: card type, number, expiration, and signature. Wrong amount or wrong payment type gets the whole packet returned, and your expiration date keeps approaching while it travels back and forth.

Where to Mail It

Prometric’s registry processing center address appears on each state’s form and follows this pattern:

Prometric
6211 Greenleigh Avenue, Suite 400
Middle River, MD 21220
ATTN: [Your State] Nurse Aide Registry Renewal8Prometric. Nurse Aide Registry Renewal – New York

Copy the ATTN line exactly as your form shows it; that line routes the packet to the right state team. Put the completed form, the signed verification section, and your payment in one envelope. Use a trackable mail method. Prometric does not usually confirm receipt, so a USPS tracking number or certified mail receipt is the only proof you have that the packet arrived.

New York has an online registry portal at registry.prometric.com for status lookups and some verification tasks, but the renewal form itself is still a paper submission in Prometric states. Check your state’s instructions before assuming otherwise.

After You Mail It

Processing times vary by state and volume, running from a few weeks up to 30 days or more. Submit at least 60 days before your expiration if you can, so there’s time to fix anything that comes back.

You can check your current expiration date on your state’s public nurse aide registry lookup. Once Prometric processes the renewal, the expiration date updates to the new period. Some states also mail a certificate or wallet card, which may arrive weeks after the online record changes.

Why Renewals Get Rejected

Most returned packets fail for a short list of reasons:

  • Work dates on the verification fall outside the 24-month window.
  • The hours listed are orientation, training, or in-service rather than regular CNA shifts.6Minnesota Department of Health. Nurse Aide Registry Tutorial – Submitting Your Renewal Application
  • The verification was signed by someone without the required credential.
  • Payment is the wrong amount, an expired card, or an unaccepted method like a personal check.
  • The name on the form doesn’t match the registry, usually because of an unreported name change.

Fix the issue and resend as soon as the packet comes back. You can’t work as a CNA on an expired certification; federal rules require nursing facilities to verify registry status before letting anyone serve in the role.9eCFR. 42 CFR 483.35 – Nursing Services

If Your Certification Has Already Lapsed

If more than two years have passed since expiration, the standard renewal form is no longer an option. You’ll need to retake and pass the competency evaluation (the written or oral exam and the clinical skills test).10California Department of Public Health. How to Complete Your Renewal Application Some states go further: Georgia requires a full new state-approved training program if the certification has been expired three years or more.5Georgia Nurse Aide Registry. Georgia Nurse Aide Registry – Nurse Aide Certification Renewal Retest fees commonly run $150 or more, so staying ahead of the deadline is almost always cheaper.

Getting Help from Prometric

For a closed facility, a name discrepancy, or a form that seems to have vanished, Prometric’s nurse aide registry team answers at 1-866-794-3497 (Option 2, then Option 1), Monday through Friday, 8 a.m. to 6 p.m. Eastern. Email is OpsServiceTeam@prometric.com.11Prometric. New York Nurse Aide Exam Have your certification number and Social Security number ready; the representative needs them to pull your record.