You must attach documentation to support your proof of work when you complete this form. The application should only be submitted if you have proof of work (8 hours of qualifying work, every 2 years, from the your most recent certification date).Work history must be during the certification's active status, it can be volunteer work, CMT, Med Assistant, or Patient Care Tech work. You must upload a paystub or w2 to support the qualifying work.
Acceptable documents include:
- Paystub
- W-2
- Letter from employer, signed on letterhead
- If working for a Staffing Agency - work schedule or pay summary
- If working in private duty - letter from the caregiver that includes patient name, CNA name and certificate number, dates worked/paid for, work done (give a brief description of work done - CMT/Med Assistant qualifies as well), signature of both patient and CNA, dated.