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Upload CDPH 283 D (PDF) - HHA Initial application
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Upload CDPH 283 D
Please upload your completed CDPH 283 D form (Home Health Aide Application). This form is required by the California Department of Public Health to start the Nurse Assistant certification process.
Upload Your California State ID or Driver’s License*
Upload ID
Please ensure your ID is legible and includes your full name and photo. This is required for identity verification and enrollment purposes.
Upload Your COVID-19 Vaccination Card*
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Upload Card
Please upload a clear photo or scan of your COVID-19 Vaccination Card. This is required for CNA clinical training at Skilled Nursing Facilities to ensure safety.
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