ALL SECTIONS MUST BE COMPLETED. ALL ATTACHMENTS MUST BE NUMBERED WITH THE APPLICABLE SCHEDULE/SECTION AND QUESTION #.
GENERAL INSTRUCTIONSPlease be advised that this application will require uploading files. Please be prepared with all of the supporting documentation at the time of submission. Complete each question as identified in all Parts of this application. Attach all pertinent documentation where indicated within the application.
Please ensure the Operator’s Certification in Part IV is signed by the agency’s director or administrator.
If you have any questions about the application, contact the Bureau of Professional Credentialing and Training Programs email to:pcatp@health.ny.gov
IMPORTANT NOTICE
The Department of Health will not approve any Personal Care Aide Training Program that charges any type or form of tuition and/or fee in exchange for personal care aide training.
Any personal care aide training program, regardless of sponsor, that requires the trainee to pay any amount of tuition or other fees in connection with receiving and/or completing personal care aide training or a personal care aide certificate of completion, MUST obtain New York State Education Department (SED) approval to operate the training program and will not be approved by the New York State Department of Health.*When attaching documents, please label each attachment with the name/title of the item being attached.*
If you are attaching more than one document for a question, click the browse button as many times as needed (10 max).
If more than 10 files need to be uploaded, attach the documents in a zip file.
*** Please follow the designated naming conventions when uploading files to avoid potential delays or rejection.***