How to Fill Out and Submit the New York CNA Reciprocity Application (Prometric)

To transfer an out-of-state CNA credential to New York, you submit the New York CNA reciprocity application to Prometric, the company that runs the New York State Nurse Aide Registry for the Department of Health. The packet costs $50, goes to Prometric’s office in Middle River, Maryland, and, once verified, adds your name to the New York registry so you can work legally in the state. The process comes down to one form, one fee, and proof that your current certification is clean and active.

Who Qualifies

Three conditions have to be true before you apply. You must hold an active, current certification on at least one other state’s nurse aide registry. You must be in good standing on every registry where you appear, meaning “no findings or convictions of resident abuse, neglect or misappropriation of resident belongings.”¹ And you must have worked at least one paid shift as a CNA within the past 24 months.

The good-standing rule comes from federal law, not just New York policy. Under 42 CFR 483.12, nursing homes cannot employ anyone with a substantiated finding of abuse, neglect, or misappropriation of property in any state registry.² Those findings stay on the registry permanently unless overturned by a court or made in error.³ A single substantiated incident in any state ends the reciprocity path.

Getting the Right Form

The form is the New York Certified Nursing Assistant Examination Application, a six-page packet used for both exam candidates and reciprocity applicants. There is no separate reciprocity-only form. You can download it from the New York State Department of Health’s nurse aide registry page or from Prometric at prometric.com/NurseAide/NY.⁴ Prometric’s site also lists an online option at the same URL, though most applicants use the paper packet by mail.

One clarification worth making before you file anything: this application is sometimes misidentified as “Form DOH-4330.” That is a different document entirely, a controlled substance license application handled by the Bureau of Narcotic Enforcement.⁵ If you pulled up DOH-4330 expecting a CNA form, you have the wrong one. Look for the packet titled “New York Certified Nursing Assistant Examination Application” with the Prometric logo.

Filling Out the Application

Because the form covers multiple certification routes, the first thing to do is check the box for “Route 2. Reciprocity/CNA From Another State” in the certification route section.¹ Checking the wrong route, or skipping it, is a quick way to have your packet sent back.

The personal information section asks for your full legal name, and the application warns that the name must match exactly what appears on your government-issued photo ID. If your name has changed since your last certification through marriage, divorce, or a court order, include a copy of the supporting legal document (marriage certificate, divorce decree, birth certificate, or court name-change paperwork).¹

The out-of-state registry section asks you to list every state where you currently hold a nurse aide certification and to indicate whether you are in good standing on each. Be thorough. Prometric verifies across state registries, and an omitted state will show up as a gap that delays your file.

Print clearly or type. The application states that incomplete, blurred, or illegible forms will not be processed. Photocopy every completed page for your records before mailing.¹

Payment and What to Include

The reciprocity fee is $50, non-refundable and non-transferable.¹ Here is where most correctable mistakes happen. The check or money order must be made payable to “New York State Commissioner of Health, NYNA,” not to Prometric. Write your name and ID number (if you have one) on the payment itself.⁶

Only certified checks and money orders are accepted. Personal checks and cash will send the entire packet back to you. The last page of the application is a payment form that has to be included no matter how you pay.

What to gather before mailing:

The completed application, with Route 2 checked.
A certified check or money order for $50, payable to New York State Commissioner of Health, NYNA.
The payment form (last page of the application).
Legal name-change documents, if your current name differs from the name on your out-of-state certification.
A photocopy of everything you send, kept for yourself.

Where to Mail It

Send the completed original application, supporting documents, and payment to:

Prometric
ATTN: NY Nurse Aide Program
6211 Greenleigh Avenue, Suite 400
Middle River, MD 21220¹

Prometric moved to this Middle River address in late 2025. Older references pointing to Aberdeen, Maryland, are outdated. Send the packet with tracking so you can confirm it arrived; if Prometric returns it as incomplete, you want to know it reached them in the first place.

After You Submit

Once Prometric has your packet, staff verify your identity and contact the nurse aide registries of every state you listed to confirm your certification status and check for any findings of abuse, neglect, or misappropriation. Every state maintains and shares this information under federal rules, so the verification involves cross-referencing multiple databases.⁷

No publicly available source confirms an exact processing time for reciprocity applications. Figures like 10 to 15 business days have circulated but cannot be verified. If you need to start work by a specific date, apply well in advance and follow up with Prometric directly rather than counting on a set window.

You can check whether your name has been added to the registry using the online public search tool on Prometric’s registry website or by calling the automated line at 1-800-918-8818, available 24 hours a day.⁸ New York does not issue a paper certificate by default. Your listing on the registry is your credential, and employers verify it electronically.

Keeping the Certification Active

Once you are on the New York registry, the credential is not permanent. To renew, you need to have worked at least seven paid hours as a nurse aide in a healthcare facility within the 24 months before your expiration date, and a Director of Nursing or designee at your facility must sign the renewal form to verify the work.⁹

The renewal is a separate form, available on both the Prometric and Department of Health sites. The renewal fee is $40, paid by certified check or money order to “NY Commissioner of Health, NYNA,” mailed to the same Middle River address but marked ATTN: NY Nurse Aide Registry Renewal.⁹ If you let the certification lapse by missing the work requirement, you may have to retake a competency evaluation to get back on the registry.

Mistakes That Get Applications Sent Back

Packets get returned for a predictable set of reasons. Knowing them saves weeks:

Check made out to Prometric instead of “New York State Commissioner of Health, NYNA.” This is the most common payment error.
Paying by personal check or cash. Neither is accepted, and the whole packet comes back.
Leaving out the payment form on the last page of the application.
Application name that does not match your government ID, with no legal document explaining the change.
Failing to list every state where you have held certification.
Illegible handwriting. The application says blurred or unclear forms will not be processed.
Checking the wrong certification route. Reciprocity applicants use Route 2.

1
Prometric. New York Certified Nursing Assistant Examination Application
2
eCFR. 42 CFR 483.12 – Resident Rights
3
eCFR. 42 CFR 483.156 – Registry of Nurse Aides
4
New York State Department of Health. Nurse Aide Registry
5
New York State Department of Health. Bureau of Narcotic Enforcement License Application Instructions
6
New York State Department of Health. CNA Examination Application
7
eCFR. 42 CFR 483.156 – Registry of Nurse Aides
8
New York State Department of Health. Using the Nurse Aide Registry
9
Prometric. New York State Nurse Aide Registry Renewal