Adult Care Licensure Section

General Information

Exam Fees

Type of Exam	Testing Fee	Pre-Registration Required
Administrator	$50.00	Yes
Alternative	No charge	Yes

Payment must be in the form of a money order or certified check made payable to "DHSR". Personal or company checks are not accepted. Improper forms of payment will delay in registering for your test site. Fees are non-refundable and non-transferable once submitted to DHSR. Payment will not be accepted at testing locations. Administrator registration forms must be mailed with appropriate testing fee.

• Use only a number two pencil to complete the form. The machine that reads the form will not accept a form completed in ink.
• Read the instructions for items 1 through 12 if you are registering for the medication exam. Make sure you answer all items 1 through 12 that apply to you.
• Make sure you completely fill in all marked circles. Make solid marks that fill the circle completely. Refer to block "Instructions" on the registration form. Incorrect or incomplete entries or non-payment of a registration fee may delay the scheduling of your written test. All items marked with ** listed in the instructions must be completed.
• Do not tear, crumble, or damage the form in any way. If the form is damaged in any way, the form cannot be scanned and we will not be able to schedule you to take the written test. Refold the form and return it to the address below in a long business envelope. You are responsible for postage to mail back your registration form and testing fee. Make sure the correct postage is on the envelope. Mail the completed form to one of the following addresses listed below:
  
  

  Regular (USPS) Mail:		Express/FedEx or UPS Mail:		In Person Registration & Payment for Administrator Testing: cash, money order, or certified check
  NC Division of Health Service Regulation		NC Division of Health Service Regulation		NC Division of Health Service Regulation
  Health Care Personnel Education & Credentialing		Health Care Personnel Education & Credentialing		Health Care Personnel Education & Credentialing
  2709 Mail Service Center		809 Ruggles Drive		Brown Building, 801 Biggs Drive
  Raleigh, NC 27603		Raleigh, NC 27699-2709		Raleigh, NC 27603

• Use only an eraser to correct any circles marked by mistake (do not use liquid "white out" and do not make an "X" mark on top of the circle)
• Do not make any stray marks on the form
• Only one letter or number is written in a block. Fill in the circle in each column that matches the number or letter that is written in the block above the column. Do not fill in more than one circle per column.
• Please get someone to assist or fill out the form for you if you have problems completing the form.
• If you have special needs or require special assistance that we need to be aware of at the test site, this information is to be provided on a separate piece of paper and mailed with your registration form. We must be informed prior to the time of registration.

Instructions for Items 1 through 12

Click here for instructions for completing the scantron registration form and print the registration form (pages 4 and 5).

After completing items 1-12, mail the form to the Division of Health Service Regulation. Go to the top of the page under General Instructions for address and mailing instructions.

A confirmation letter will be mailed to you once you have been registered to take the written exam.

All applicants may check on registration by calling the Health Care Personnel Education and Credentialing Section at 919-855-3969.