This form is for MSDH-approved Nurse Aide Instructors in Mississippi who would like to request access to TMU©.

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 Mississippi.

This form is for MSDH-approved Training Programs in Mississippi who would to request access to TMU©.

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

Application to be certified as an Actor for Mississippi nurse aide competency testing.

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

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

Application to petition for removal of a finding of neglect from the Mississippi Nurse Aide Registry to give a CNA an opportunity to request that a single entry of neglect be removed from the Mississippi Nurse Aide Registry.

Application to bypass the Mississippi State Department of Health (MSDH) training requirement for students currently enrolled in an MSDH-approved pre-licensure program of nursing education.

Complete this form for out-of-state work or if your employer no longer exists to qualify for renewal on the Mississippi nurse aide registry.

Application to bypass the Mississippi State Department of Health (MSDH) training requirement for LPN or RN program graduates who have completed a Mississippi-approved LPN or RN program within the past twenty-four months.

Application to bypass the Mississippi State Department of Health (MSDH) training requirement for LPN or RN program graduates who have completed an LPN or RN program outside the state of Mississippi. Before filling out this application, please call the Mississippi State Department of Health to request an Approval to Test letter at (601) 364-1100.

Mississippi Reciprocity Form - for placement on the Mississippi Nurse Aide Registry via Interstate Transfer.

This application is for candidates who were previously certified on the Mississippi Nurse Aide Registry and are reactivating their exam through testing.

Candidate Attestation of previous Mississippi NA Successful Completion of Training Application

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.

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.

Complete this form if you need to submit No Show Exception documentation.

This application is for candidates who were previously certified on an official Certified Nurse Aide Registry outside the state of Mississippi and are reactivating their exam through testing.