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The Certified Nurse Aid course requires a great deal of paperwork to be completed.  Some forms are required for the University, some for the State of Alaska and the majority are required for the Ketchikan General Hospital to complete clinicals.  Following is a list of the required paperwork:

UAS Ketchikan Campus:

  • Code of Conduct/Student Agreement
  • Course Registration Form (Course fee due at time of registration)

 State of Alaska:

  • Application for Certified Nurse Aide by Exam (with passport photo - requires additional cost)
  • Fingerprints (requires additional cost)

Ketchikan General Hospital:

  • Student Contact Info Sheet
  • Background check from the Alaska State Troopers (requires additional cost)
  • State of Alaska DHSS Check
  • Liability Waiver
  • Student Agreement
  • Confidentiality Form
  • Code of Ethics
  • HR Policy Manual Review & Quizzes (to be completed over the web)
  • Respiratory Questionnaire
  • Health Forms
    • TB Test Results
    • Titers
    • Hepatitis B Declination Form
    • Latex Allergy Questionnaire
    • Employee Health Exam Questionnaire
    • Health Care Practitioner Exam (to be completed by your doctor during physical exam)

These forms will be reviewed at the Mandatory Orientation Sessions held prior to the course registration.  When packets are complete, please contact Abby Kosmos at (907) 228-4537 to schedule an appointment to review packet.


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