To apply for a Temporary Administrator or Manager License, create your account in the Applicant Portal Choose: "New user? Apply Now"
Letter of Intent forms for Temporary Administrator and Temporary Manager are found on page 2 at Resources
The Public Records Request form is used for requesting copies of public records from the Board or requesting administrator and manager mailing lists. Please email your completed form to [email protected] A member of our staff will contact you to advise of any fees that may be associated with your request.
A list of Licensees can be found, free of charge, on the Online Registry
A Duplicate Manager Certificate is $75. To request a duplicate, log into your Licensee Portal and complete the required fields and payment in the Requests > Duplicate Certificate section found on the left navigation pane.
A Duplicate Administrator license is $75. To request a duplicate, log into your Licensee Portal and complete the required fields and payment in the Requests > Duplicate Certificate section found on the left navigation pane.
CEU extension request form can be used to request an extension of time to complete the CEU requirement for license or certificate renewal. The form must be filled out and uploaded with your renewal, along with the CEU certificates you are submitting with your renewal.
Assisted living facility caregivers; trainng and competency requirements; medication administration; testing