Maine Registry of Certified Nursing Assistants (CNA Registry)

Notice: To report complaints of abuse, neglect, or misappropriation call the complaint line: 1(800)383-2441

Applications Forms

Hardcopies of the following forms are available by calling the CNA Registry at 624-7300 or send your request via e-mail to: dlrs.cnaregistry@maine.gov:

• Bridge Examination application form
• CNA-M application form
• CNA's Trained in Maine (Word*) | also in PDF*
• CNA's Trained out of the State (Word*) | also in PDF*
• Competency testing application form
• Confirmation of Listing on the Registry form
• Petition for Removal of a Finding of Neglect form
• Provider Confirmation of Hire or Termination of CNA form
• Reciprocity form
• Renewal form
• Request for Temporary Listing on the Registry form