Become a Certified Nurse Aide in Texas (2024)

Traditional Route Process Map (PDF)

• Complete Nurse Aide Training and Competency Evaluation Program (NATCEP) training: Applicant successfully completes a state-approved nurse aide training program (60 hours of classroom and 40 hours of clinical) or the HHSC computer-based training (CBT) 60-hour online classroom training and 40 hours of clinical training with a state-approved nurse aide training and competency evaluation program.
  • A searchable directory is available on the HHS Credentialing NATCEP Training Providers webpage.
  • Register for the NATCEP computer-based training course.
  • Learn more: Online Training Guidelines for Nurse Aide Trainees – PL 2024-07 (PDF).
• Submit an application through TULIP: Students who have successfully completed a training program or the HHSC CBT are required to submit a New Nurse Aide by Examination Application in TULIP. Select New Nurse Aide under the Eligibility Route tab. Log in to TULIP to create an applicant registration and reset password.
  • HHSC staff review the application. If there are deficiencies, they place the application in Response Required so the applicant can correct it.
• NATCEP approval: The program director of the training program where the training was received is required to approve the training in TULIP. The student receives an email from SMT Notice with a link to register for the exam.
  • NATCEP approval is based on:
    • Successfully completing the training.
    • Successful background check based on requirements in Texas Health and Safety Code 250.006.
    • Student not listed on the Employee Misconduct Registry.
  • Prometric handles scheduling and testing. Call 800-488-5787 or email TXCNA.
• Schedule and pass the exams: Student schedules and passes the written and skills exams.
• Certification is issued: Exam scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.

Nurse aides that have an active certification in another state may transfer their certification to Texas.

Reciprocity Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Log in to TULIP to create an applicant registration and reset the password. Then complete a Request for Entry on the Texas Nurse Aide Registry through Reciprocity application.
  • If the state that issued the applicant’s certification doesn’t provide an expiration date, the applicant will need to complete. Form 5506-NAR (PDF).
  • TULIP requires the applicant to upload criminal history results, Form 5506 if needed, the nurse aide certificate in the other state, valid government-issued photo ID and social security card.
  • HHSC staff will review the application and all documentation. If there are deficiencies, they place the application in Response Required so the nurse aide can correct it.
    • Staff check the Employee Misconduct Registry.
• Certification issued: If approved, HHSC staff issue a nurse aide certificate, and the applicant receives an email from TULIP.
  • The certificate can be printed from TULIP.

The spouse of an active military service member and have an active nurse aide certificate in another state. HHSC will issue a Texas nurse aide certificate for three years, as long as the applicant maintains active status in the other state. The applicant chooses whether to pursue this waiver or reciprocity.

Military Spouse Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System and then complete a Nurse Aide Certificate for Military Spouse Stationed in Texas Application.
  • If the state that issued the applicant’s certification doesn’t provide an expiration date, the applicant will need to complete Form 5506-NAR (PDF).
  • TULIP requires the applicant to upload the criminal history results, Form 5506 if needed, a valid government-issued photo ID, the applicant’s military ID, spouse’s military orders, the applicant’s social security card, proof of current address in Texas (such as a utility bill), and the nurse aide certificate from another state.
  • HHSC staff review the application. If they find any deficiencies, they place the application in Response Required so the applicant can correct it.
    • Staff check the Employee Misconduct Registry.
• Certification issued: If approved, HHSC issues a Texas nurse aide certificate for three years, as long as the applicant maintains active status in the other state. Once issued, the applicant receives an email from TULIP. HHSC will email the applicant a verification letter.

Applicants that have successfully completed the training portion of an approved NATCEP in another state in the last 24 months but have not completed the exam or been placed on a registry in another state.

Out-of-State Training Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System and then complete a New Nurse Aide by Examination application. Under the Eligibility Route tab select Out-of-State Training.
  • TULIP requires the applicant to upload the criminal history results and out-of-state training certificate.
  • HHSC staff review the application. If there are deficiencies, they place the application in Response Required so the applicant can correct it.
    • Staff check the Employee Misconduct Registry.
• Approval to test: HHSC staff mark the applicant as eligible to test in TULIP. The applicant receives an email from SMT Notice that provides a link to register for the exam.
  • Prometric handles scheduling and testing. Call 800-488-5787 or email TXCNA.
• Schedule and pass the exams: Applicant schedules and passes the written and skills exams.
• Certification issued: Exam scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.

After July 1, 1989, the applicant successfully completed military training of 100 hours or more equivalent to civilian nurse aide training.

Equivalent Military Training Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System and then complete a New Nurse Aide by Examination application. Under the Eligibility Route tab select Nurse Aide with Equivalent Military Training.
  • TULIP requires the applicant to upload the criminal history results and proof of military training (such as, DD214).
  • HHSC staff review the application. If any deficiencies are found, they place the application in Response Required so the applicant can correct it.
  • Staff check the Employee Misconduct Registry.
• Approval to test: HHSC staff mark the applicant as eligible to test in TULIP. The applicant receives an email from SMT Notice that provides a link to register for the exam.
  • Prometric handles scheduling and testing. Call 800-488-5787 or email TXCNA.
• Schedule and pass exams: Applicant schedules and passes written and skills exams.
• Certification issued: Exam scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.

After July 1, 1989, the applicant successfully completed a state-accredited registered nurse (RN) or licensed vocational nurse (LVN) school but was not licensed as an RN or LVN in Texas, or they held a license that’s been revoked.

RN/LVN Graduate Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System and then complete a New Nurse Aide by Examination application. Under the Eligibility Route tab select RN/LVN Graduate.
  • TULIP requires the applicant to upload the criminal history results and RN/LVN diploma.
  • HHSC staff review the application. If any deficiencies are found, staff place the application in Response Required so the applicant can correct it.
  • Staff check the Employee Misconduct Registry.
• Approval to test: HHSC staff mark the applicant as eligible to test in TULIP. The applicant receives an email from SMT Notice with a link to register for the exam.
  • Prometric handles scheduling and testing. Call 800-488-5787 or email TXCNA.
• Schedule and pass exams: Applicant schedules and passes written and skills exams.
• Certification issued: Exam scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.

Applicant is currently enrolled in a state-accredited school of nursing in any state and has demonstrated competency in providing basic nursing skills in accordance with the school’s curriculum.

RN/LVN Student Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System. Complete a New Nurse Aide by Examination application and under the Eligibility Route tab select RN/LVN Student.
  • TULIP requires the applicant to upload the criminal history results and proof of completion of the first semester of RN/LVN school.
  • HHSC staff review the application. If any deficiencies are found, they will place the application in Response Required so the applicant can correct it.
  • Staff check the Employee Misconduct Registry.
• Approval to test: HHSC staff mark the applicant as eligible to test in TULIP. The applicant receives an email from SMT Notice with a link to register for the exam.
  • Prometric handles scheduling and testing. Call 800-488-5787 or email TXCNA.
• Schedule and pass exams: Applicant schedules and passes written and skills exams.
• Certification issued: Exam scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.

Applicant completed an approved NATCEP in Texas in the past two years, but the NATCEP is closed.

Training Program Closed Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System. Complete a New Nurse Aide by Examination application and select Training Program Closed under the Eligibility Route tab.
  • TULIP requires the applicant to upload the criminal history results and certificate of completion of the NATCEP.
  • HHSC staff review the application. If any deficiencies are found, they place the application in Response Required so the applicant can correct it.
  • Staff check the Employee Misconduct Registry.
• Approval to test: HHSC staff mark the applicant as eligible to test in TULIP. The applicant receives an email from SMT Notice with a link to register for the exam.
  • Prometric handles scheduling and testing. Call 800-488-5787 or email TXCNA.
• Schedule and pass exams: Applicant schedules and passes written and skills exams.
• Certification issued: Exams scores are electronically sent to TULIP from the Prometric system. HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.

Applicant completed a nurse aide training program prior to July 1, 1989, and has continued to work as a nurse aide every two years since the training was completed.

NA Training and Competency Evaluation Waiver Process Map (PDF)

• DPS criminal history check: Complete a criminal history check through the Texas Department of Public Safety Crime Records division for all last names the applicant has had. There is a fee for each check.
• Complete required forms:
  • Complete a Request for Waiver of Nurse Aide Training and Competency Evaluation – Form 5507 (PDF).
  • Complete an Employment Verification – Form 5506-NAR (PDF) for every two years the applicant has worked as a nurse aide since the training was completed.
• Submit an application through TULIP: Apply through the TULIP Online Licensure Application System. Complete a New Nurse Aide by Examination application. Select Request for Waiver of Nurse Aide Training and Competency Evaluation under the Eligibility Route tab.
  • TULIP requires the applicant to upload the criminal history results, forms 5507 and 5506, certificate of completion for nurse aide training or transcript, a valid government-issued ID and social security card.
  • HHSC staff review the application. If any deficiencies are found, staff place the application in Response Required so the applicant can correct it.
  • Staff check the Employee Misconduct Registry.
• Certification issued: HHSC staff issue the certificate and change the application in TULIP to “Approved.” TULIP emails the applicant.
  • The certificate can be printed from TULIP.