Georgia - Nurse Aide Program

*** Attention ***

All Certified Medication Aide on-line renewal forms MUST have a completed standardize comprehensive medication skills checklist form signed by a Georgia licensed Registered Nurse or Pharmacist or Physician within the past 18 months. The skills checklist MUST be scanned and attached to the on-line renewal submission. The on-line renewal submission will not process without the attached skills checklist.

A renewal form can be printed from www.mmis.georgia.gov, click on the Medication Aide Tab. Mail the renewal form with a copy of the required skills checklist form to the address on the form.

Certified Medication Aide Information
Last Name :	Required	First Name :	Required	Middle Initial:
Certification Number :	Required Please enter numeric values only	Social Security Number :	Required Invalid	Date of Birth :	*Invalid
Address Line 1 :	Required	Address Line 2 :
City :	Required	State :	Required Zip :- Required Invalid	County :	Required
Email :	Required Invalid email	Phone :	Invalid Ext.
Employer Information
Current Employer :	Required	Employer Type :	Required
Address Line 1:	Required	Address Line 2:
City :	Required	State :	Required Zip :- Required Employer Zip Invalid	County :
Phone :	Invalid Ext.	Date Hired :	*	Date Employment Ended :

Comments :

CMA RENEWAL AND SKILLS REC'D STATUS UPDATED - NEKEYIA.THOMAS, 01/10/2024 10:12:42 AM

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The information entered and attached was received successfully. Please allow up 30 business days for processing. Check the web portal at www.mmis.georgia.gov
for Certified Medication Aide updates. Certification cards are not available for Certified Medication Aides.

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