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TEST SITE Application

Please complete this application to become an approved Test Site. In the Affidavit at the end of this document, you will attest that you have read, understood, and will abide by the terms outlined on this application.

Once you have completed all the fields in this application and uploaded the required images, select “Send Application" to submit it.
Address
Mailing Address
Additional Facility Information
Candidate Directions
Test Site Information
Affidavit
As an Iowa Nurse Aide Testing Site, we agree to:

1. Supply an approved, distraction-free, and interruption-free area for testing nurse aide candidates on the
Knowledge Exam.
2. We will provide internet-connected computers in an area that allows 3-4 feet of separation between candidates.
3. Create test events in TMU©, including linking a Knowledge Test Proctor (KTP) who has committed to the test event
for the test dates created.
4. Use TMU© to schedule test seats for our candidates. (Link to TMU© at ia.tmutest.com)
5. Hold test teams and test candidates accountable for damage, theft, or any other act or action harmful to the facility
in any way.
6. Assume all liability for our test candidates.
7. Waive liability claims against D&SDT-HEADMASTER for assuming any liability for any of the entities involved in
testing (D&SDT-HEADMASTER-certified RN Test Observers, KTPs, or any test candidates).

Photographing, Recording or Videotaping Test Events
  •  As a certification test vendor, D&SDT-HEADMASTER must ensure the security of knowledge test items and proprietary test delivery software.
  • Certification test events are expected to be conducted in a distraction-free environment with a high degree of personal privacy
    and security. Photographing, videotaping, or recording via security or surveillance cameras or any other device while any
    knowledge testing is being conducted is expressly prohibited unless advance written permission has been granted by D&SDT-HEADMASTER and/or the Iowa Department of Inspections, Appeals and Licensing (DIAL).
  • To host certification test events for test candidates, you agree that no electronic recording devices will be used to record sound
    or video of actual test candidates, test events, or any part of test administration. You agree that to allow the recording of
    certification testing events in progress without the express written consent of D&SDT-HEADMASTER and/or the DIAL may result
    in the loss of your test site approval and/or training program approval and may subject you to prosecution by all affected parties
    to the full extent of the law.
We will attest on the Iowa TMU© Test Site Application that our Facility is under no authoritative sanctions and that we have read, understood, and will abide by all listed guidelines.

By Submitting
I hereby verify that I understand and agree with the statements contained herein and the above information is true and correct.