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Nursing Assistant Forms (Except NA I Refresher)

The following forms are required in order to attend the NA I and NA II courses (not required for the NA I Refresher course). Please complete and sign each form and bring it to the first day of class.

The forms may be filled out online then saved to your computer, printed, and signed.

Information Sheet

Clinical Training Form

Criminal Background Check – Durham Tech encourages students to complete the criminal background check one week prior to the first day of class. Students are required to use the contracted vendor FirstPoint.

First Point Authorization Form – Allows Durham Tech or the clinical site to view your background check.

Hepatitis B Refusal Form – Students must show proof of immunization to Hepatitis B by bringing an immunization record OR they may decline to receive the vaccine. For declining the vaccine, or until your health records can be located and submitted, the student must complete the form. Please include your age in the appropriate area.