Training Program and Instructor Application Forms

These forms are used by adult family homes, assisted living facilities, and community instructors to request DSHS approval to offer long‑term care worker training, submit or use curriculum, and update existing program information. The list includes all current training and instructor applications.

Adult family homes, assisted living facilities, and community instructors use these forms to request DSHS approval for the following:

  • To offer long-term care worker training, including orientation, safety, basic training, population specific, specialty, nurse delegation core, nurse delegation diabetes, and continuing education.
  • To offer curriculum you have developed.
  • To use curriculum developed by DSHS or another entity.
  • Updates for existing training program information.

 

The forms below have recently been updated, including their names.

  • Continuing Education Event Approval Application (DSHS 15-547 PDF | Word)
  • Adult Family Home Administrator Training Instructor Application (DSHS 15-548 PDF | Word)
  • DSHS Adult Education Instructor Application (Home and Community Services) (DSHS 15-549 PDF | Word)
  • Community Instructor Application (DSHS 15-550 PDF | Word)
  • Community Instructor Training Program Application and Updates (DSHS 15-551 PDF | Word)
  • Curriculum Approval Application (DSHS 15-552 PDF | Word)
  • Facility Instructor Application (DSHS 15-554 PDF | Word)
  • Facility Training Program Application and Updates (DSHS 15-555 PDF | Word)
  • On-the-Job Skills Training Application (DSHS 15-567 PDF | Word)
  • Contractor Intake (DSHS 27-043 PDF | Word)
  • High School Home Care Aide Training Program and Instructor Application (14-533 PDF| Word)