• An Overview of the Rehab Committee
• Frequently Asked Questions

• GNA Abuse Registry - Posting Required by DHMH Office of Health Care Quality.
• Applicants denied licensure and certification

• Board Order Fine Form
• Rehab Treatment Verification Form
• ​Employer Notification of Board Order Form
• Self Report for Probation Orders 
• Self Report Form for Monitoring
• Treatment Verification Form
• Worksite Verification Monitoring Program Form​​ 
• Worksite Report 2015 Monitoring Form
• Worksite Report 2015 Probation Form 
• Complaint Form
• Treatment Progress Report

Contact the Discipline & Compliance Division

For general inquiries (Discipline):
[email protected]

For general inquiries (probation/reinstatement after discipline):
[email protected]

For general inquiries (Safe Practice Program):
[email protected]

^{updated 08/24/2023}