Click to download the form:
Instructions: **** Reinstatements are only done by mail
If your certifications has lapsed you will need to fill out a reinstatement form and pay the $200 reinstatement fee not a renewal form
Please mail the completed reinstatement form with the $250 Reinstatement fee to the following Payee and address:
National Healthcare Workers Association
378 Boston Post Road Suite 1000 Orange CT 06477
Instructions: * Renewal can be done online or by mail
If you are just renewing your certification and it has not lapsed you can renew online by filling out the form below and making the $105 payment on our website, You can also mail the renewal form below with the $105 payment to
National Healthcare Workers Association
378 Boston Post Road Suite 1000 Orange CT 06477
Please fill out the form below to purchase your certification renewal.