Please note: This page is designed for the regulation of Nursing Assistant and Medication Assistant Programs

Information for students and the public (Including AZ Approved Program Lists) can be found here.

Nursing Assistant Training Program Application Forms

Use the following forms to become an approved Arizona CNA/CMA program or to renew your existing program.

• Application Instructions
• NA Application and Checklist
• Consolidated Program Renewal Application Supplement Sheet
• Additional Page - Clinical Sites
• Additional Page - Instructors
• Nursing Assistant Curriculum
• Template for Nursing Assistant Program Evaluations
• Lab Supply List
• Skills Checklist - Class and Clinical Combined
• Skills Checklist - Classroom
• Skills Checklist - Clinical
• Bond Form
• Long Term Care (LTC) Affidavit

Online Submission Forms

• Nursing Assistant Program Change Form
• Application to Consolidate or ADD to an Existing Consolidated Program
• Coordinator Change Form
• Instructor Change Form

Medication Assistant Program Forms

• Medication Assistant Program Application and Checklist

Please contact Kathy Malloch ([email protected]) or Cindy George ([email protected]) for more information.