Transcription of Home Care Aide Certification Application Packet
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Home Care Aide Certification Application Packet
DOH 675-002 September 2017 Home Care Aide Certification Application PacketContents: 1. 675-002 ..Contents List/SSN Information/Mailing Information ..1 page2. 675-003 .. Certification Requirements and Application Instructions Checklist ..4 pages3. 675-005 ..Home Care Aide Certification Application ..7 pages4. 675-006 ..Employment Verification ..1 page5. 675-007 ..Out-of-State Credential Verification form ..2 pages6. RCW/WAC and Online Website Links ..1 pageImportant Social Security Number Information:You are required by state and federal law to provide a social security number with your Application .
employment verification form from the employer they worked for between January 1, 2011 and January 6, 2012. F Out-of-State Credential Verification Form: If you worked as a healthcare provider in another state or jurisdiction, submit a copy of the verification form to each state you hold or have held a healthcare license,
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