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Out-of-State Nurse Aide Training Waiver Form 1101

NURSE AIDE: Out-of-State Nurse Aide Training Waiver

Waiver Student
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NURSE AIDE: RN Test Observer | Test Administration Services Entity (TASE) - $100.00

Application to be certified as an RN Test Observer/Test Administration Services Entity (TASE) for Nurse Aide Competency Exam testing services in the state of Michigan.

Observer
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Knowledge Test Proctor (KTP) Training Affidavit and Confidentiality/Nondisclosure Agreement

Application to be certified as a Knowledge Test Proctor (KTP) for Michigan nurse aide (or medication aide) competency testing.

Proctor
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Actor Training Affidavit and Confidentiality/Nondisclosure Agreement

Application to be certified as an Actor for Michigan nurse and/or medication aide competency testing.

Actor
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DEMOGRAPHIC CHANGE/CORRECTION REQUEST FORM

This form is to update, change or correct the spelling of your name or update/correct your social security number in your TMU© account.

Waiver Student
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MEDICATION AIDE: Out-of-State Medication Aide Training Waiver

Out-of-State Medication Aide Training Waiver

Waiver Student
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MEDICATION AIDE: RN Test Observer | Test Administration Services Entity (TASE) - $65.00

Application to be certified as an RN Test Observer/Test Administration Services Entity (TASE) for Medication Aide Competency Exam testing services in Michigan. *If you are not a Michigan Nurse Aide TASE and would like to administer Medication Aide exams, please call (888) 401-0462*

Observer
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NURSE AIDE: Test Site

This application is for Facilities who would like to become approved Nurse Aide Test Sites.

Facility
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MEDICATION AIDE: Test Site

This application is for Facilities who would like to become approved Medication Aide Test Sites.

Facility
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TEST REVIEW REQUEST AND PAYMENT FORM - $25.00

This application is to request a review of your test results or dispute any other condition of your testing that you think altered the outcome of your test. You must submit the $25 non-refundable test review fee and a detailed explanation with this Test Review Request. We recommend calling D&SDT-HEADMASTER staff for a test results consultation before submitting this form with your test review fee. NOTE: Please refer to the Candidate Handbook ‘Test Review Requests’ section.

Waiver Student
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ADA ACCOMMODATION REQUEST

In compliance with the Americans with Disabilities Act (ADA), the testing program provides reasonable accommodations for applicants with disabilities that may affect their ability to take the Competency Examination.

Waiver Student
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