Gifts of Grace
Partners & Affiliates
Section I. Please complete this section prior to moving to section II.
Indicates required field
This Application is for:
Initial Medication Administration
Medication Administration Renewal
G/J Tube Medications
G/J Tube Renewal
Have you ever taken a medication administration class?
Last four digits of your social
Date of Birth:
Are you a
If you're an Independent Provider you must bring proof of high school diploma or equivalency along with proof of background check conducted within last 24 months with you to class.
* If you're an Independent Provider, you must provide proof of high school diploma or equivalency along with proof of background check conducted within the last 24 months.
Ohio Department of Developmental Disabilities Application for DD Personnel Medication Administration Certification Registration Form