PUBLICATIONS AND FORMS
- Brochure - The Division has a brochure that provides information about its services. For a copy, please contact the Division's New Castle County office or Kent/Sussex Counties office.
- Poster - The Division has a poster that gives the 24-hour, toll-free contact information for reporting complaints/incidents related to abuse, neglect, mistreatment, and/or financial exploitation of residents of long term care facilities. For a copy, please contact the Division's Investigative Section in New Castle County or Kent/Sussex Counties.
The Division has a number of forms, including those listed below. If a form is not available on the Division's website, the phone number to call to request a copy of the form is found with the link next to the name of the document.
- Incident Report (to report incidents/complaints pertaining to long term care facilities) - Call the Incident and Complaint Referral Center.
- Authorization for the Release of Adult Abuse Registry Information - Call the Adult Abuse Registry.
- Applications for Licensure - Call the Division's New Castle County office.
- Application for Certified Nursing Assistant (CNA) Renewal - Call the CNA Registry in New Castle County or Kent/Sussex Counties.
- Application for CNA Reciprocity - Call the CNA Registry in New Castle County or Kent/Sussex Counties.
- Nurse Aide Training Program Application
- CMP Request Form: Long Term Care Residents' Trust Fund. This form should be completed following the Instructions to Request Approval for Use of Civil Money Penalty Funds for Certified Nursing Homes from the Long Term Care Residents' Trust Fund.
- Delaware Durable Personal Power of Attorney.
- Uniform Assessment instrument for Assisted Living Facilities, Revised January 23, 2008.
Please contact the Division's New Castle County office to see if other forms are available.