Duplicate Certification

While there is no fee to print certification status online, you have additional options to obtain a duplicate certification: You may request a duplicate certification online or in writing by mail. Please direct correspondence to:

NHCWA

Duplicate Certification Division
378 Boston Post Road
Orange, CT 06477

Be sure to include your certification number, type of certification, your name, address and your signature on the letter. You must include a $25 certified bank check or money order made payable to the NHCWA for the duplicate certification.

Note: Always include your certification number on your check. You can also apply for duplicate certification online by filling out the form below and making payment online.

Date / Time *

Date

Time

Applicants Name *

First

Last

Date of Birth *

Gender *

Applicants Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Name of certification you are requesting a duplicate or hard copy of *

Certification Number your requesting a duplicate or hard copy of *

Has any health-related licensing, certification or disciplinary authority taken adverse action (revoked, annulled, cancelled, suspended, etc.) against you? *

- If yes, indicate the type and number of license/certificate: *

Please Upload a copy of your state issued photo ID? *

Click or drag a file to this area to upload.

Duplicate certification or hard copy *

Pay Now *

Card

Name on Card