2023 Nurse Aide Training Program Annual Report, F-62593 (12/2023)

Program Details

In accordance with state and federal requirements, all approved nurse aide training programs must submit an annual report to the Division of Quality Assurance (DQA). All nurse aide training programs approved to operate for the period of January 1, 2023 to the present, are required to provide DQA with training information, even if class was not conducted.

NOTE: You will need to complete a separate survey for each approved training program. Upon submission of your first program, you will receive a "thank you" email with a link to return to the survey to complete annual reports for any additional programs.

Please complete your annual report survey by December 29, 2023.

Select your approved nurse aide training program. *This question is required.

Other: Type the name of your approved nurse aide training program. *This question is required.

Provide the date of your most recent course: This question requires a valid date format of MM/DD/YYYY.

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Program Contact Details

Last Name *This question is required.

First Name *This question is required.

Phone Number *This question is required. This question requires a valid number format.

Email *This question is required. This question requires a valid email address.

Programs are required to employ primary instructors and program trainers who meet requirements described in Wis. Admin. Code § DHS 129.06.

The program's primary instructor(s) and trainer(s) have been approved by the Division of Quality Assurance. *This question is required.

The program's classrooms and clinical sites have been approved for use by the Division of Quality Assurance per the requirements described in Wis. Admin. Code §§ DHS 129.07(2)a-c. *This question is required.

Is your facility a test site?

What type of test site is your facility?