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INAP Forms

INAP Handbook
An overview of the Iowa Nurse Assistance Program can be found at this link: INAP Handbook

Important Forms

To self-report for consideration of admission to the program, please complete and submit the following forms. Click on the blue link to access the document:
   INAP Self Report Form
   INAP Release of Information Form
   INAP Intake Form

Fax, mail or email the forms to the attention of the INAP Program Coordinator. 

Confidential Fax: 515.725.4017
Mailing address: INAP, 400 SW 8th St, Suite B, Des Moines, IA 50309
Email:INAP@iowa.gov

Participant Forms

Click on the blue link below to access the document:
INAP Quarterly Support Groups Form
INAP Yearly Prescription List
INAP Work Site Monitor Form
INAP Employer/Address Change Form
INAP Treatment Provider Form
INAP Aftercare Form