Register as a temporary nursing service agency

Apply for initial registration for a temporary nursing service agency (nursing pool), or register a change of ownership.
If your application is complete and acceptable, including payment as required, the Department of Public Health will assign a registration number effective the date of receipt of your application.

Division of Health Care Facility Licensure and Certification

The Details of Register as a temporary nursing service agency

What you need for Register as a temporary nursing service agency

Registration information

  • Temporary Nursing Service Agency Name (name by which you will do business)
  • Applicant Name (Individual Owner, Partnership, Limited Partnership, Corporation Name)
  • Address From Which Agency Will Do Business in Massachusetts (Street, City/Town, ZIP)
  • Telephone Number
  • Fax Number
  • Administrator’s Name
  • Owner’s Name(s) (All individuals with a 5% more ownership interest)

If applicable

  • If you are registering a change of ownership, you must attach a copy of the bill of sale or other documentation of the change of ownership
  • If you will be operating at more than one location, you must complete a separate registration application for each additional location
  • If the owner is a partnership, limited partnership, or corporation of any nature, please provide the nine digit identification number as registered with the Massachusetts Secretary of State’s office

Fees for Register as a temporary nursing service agency

Please submit one check for all registration fees, and make it payable to "Commonwealth of Massachusetts."

Name Fee Unit
Registration fee $750 each
Additional location registration fee $300 each
Change of Ownership fee $250 each
Change of Ownership additional location fee $100 each
Change of Location fee $100 each

How to register Register as a temporary nursing service agency

  1. Download and complete the Application for Initial Registration (DOCX)
  2. Mail completed application and check for fee payment(s) to:

    Licensure Coordinator
    Department of Public Health, Division of Health Care Facility Licensure and Certification
    67 Forest Street
    Marlborough, MA 01752

Contact for Register as a temporary nursing service agency

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