Registry Update Form for CNA, CMT, Insulin Certification AND Clinical Supervisors and Instructor/Examiners

In order for your name to be updated please submit clear copies of your social security card (with your current name) and one other document verifying the name change such as an updated driver's license, and/or marriage/divorce decree along with your current mailing address.

Documents may be faxed to Health Education Unit at 573-526-7656 or;
mailed to DHSS, Attn: Health Education Unit, PO Box 570, Jefferson City, MO 65102.