Wisconsin Reciprocity Form (For placement on the Wisconsin Nurse Aide Registry via Interstate Transfer.)

Application to be certified as an RN Test Observer/Test Administration Services Entity (TASE) for Nurse Aide Competency Exam testing services in the state of Wisconsin.

Application to be certified as a Knowledge Test Proctor (KTP) for Wisconsin nurse aide competency testing.

Application to be certified as an Actor for Wisconsin nurse aide competency testing.

This form is to update, change or correct the spelling of your name or update/correct your social security number in your TMU© account.

This application is for employers who would like to be registered in TMU© as an eligible employer to verify the employment of nurse aides for the renewal of their Federal certification.

This application is for Student Nurse (SN) and Graduate Nurse (GN) candidates to bypass the Wisconsin CNA training requirement to test.

This application is for Facilities who would like to become approved Test Sites.

This application is to request a review of your test results or dispute any other condition of your testing that you think altered the outcome of your test. You must submit the $25 non-refundable test review fee and a detailed explanation with this Test Review Request. We recommend calling D&SDT-HEADMASTER staff for a test results consultation before submitting this form with your test review fee. NOTE: Please refer to the Candidate Handbook ‘Test Review Requests’ section.

In compliance with the Americans with Disabilities Act (ADA), the testing program provides reasonable accommodations for applicants with disabilities that may affect their ability to take the Competency Examination.

Complete this form if you need to submit No Show Exception documentation.