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Challenge Candidate Application Form 1101

Challenge Candidate Application

Waiver Student
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Primary Nurse Aide Training Instructor Login Request Form

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

Instructor
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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 California.

Observer
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Actor Training Affidavit and Confidentiality/Nondisclosure Agreement

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

Actor
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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 California nurse aide competency testing.

Proctor
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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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Training Program Request Form

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

Facility
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TEST SITE

This application is for Facilities who would like to become approved 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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