Kentucky Interactive Username Notification

Nurse Aide Training Provider Signup.

This is for all proprietary, secondary (high-school, ATC, etc.), non-KCTCS College, and LTC facility based programs. If you pay a third-party provider to train your employees/students, do not complete this form.

Your kentucky.gov user account will need to be registered to use the new online nurse aide testing system. You are required to create one Kentucky.gov account for each nurse aide training provider # assigned to your location/facility/business. If you already have a Kentucky Interactive account, you may enter that account user ID in the form below. If you have not registered for a Kentucky Interactive account, please visit https://secure.kentucky.gov/register and complete their process.

Once registered with kentucky.gov, please complete this form that will allow us to grant your account the proper access. Failure to complete this form accurately and completely will be regarded as "no submission received" and no actions to create your account will be taken. You will be required to start the submission process over.

1. Please enter your Nurse Aide program and Kentucky Interactive information: *This question is required.

Company/School Name *This question is required.

Program Coordinator Contact Email Address *This question is required. This question requires a valid email address.

Program Coordinator First Name *This question is required.

Program Coordinator Last Name *This question is required.

Phone Number *This question is required.

If you have multiple nurse aide training provider approval numbers, you must create separate KI user accounts for each and register each one individually.

Nurse Aide Training Provider # *This question is required. This question requires a valid number format.

Kentucky Interactive User Name
Do not send passwords. *This question is required.