IN THIS GUIDE · Have the licence and the health care certificate before the border, not after
Start with the TN eligibility and application overview
The destination-state licence governs practice, not the Appendix credential by itself
Hypothetical example: a registered nurse at an Asphodel-Norwood long-term-care home accepts a medical-surgical position at a hospital across the border. Her Ontario registration keeps her employed in Canada and it is evidence of her professional standing, but it does not permit practice in an American state. Each state board licenses independently, usually through an endorsement process requiring verification from the Canadian regulator, examination results and identity checks. Apply early and keep the issued licence with the file.
The health care worker certificate is a separate statutory requirement
Federal regulation requires certain foreign health care workers, registered nurses among them, to present a certificate from an authorised credentialing organisation before admission. The certificate addresses education, licensure, examination results and English language ability. It is issued by an independent body on its own timetable and it is not something a hospital can provide. Confirm which occupations the requirement covers, apply for the certificate as early as the state licence application, and treat both as long-lead items.
The offer must be employment with a United States employer
TN requires prearranged professional employment. A hospital offering a staff position is straightforward. An agency arrangement in which the nurse is placed at facilities that direct her work needs careful analysis, because the identity of the employer and who controls the work matter, and TN does not authorise self-employment in the United States. Ask who signs the employment contract, who supervises, who sets the schedule and who pays, and get those answers before the file is built around an assumption.
Citizenship, temporariness and the port of entry
The applicant must be a Canadian or Mexican citizen; permanent residence does not qualify anyone for TN. A Canadian citizen presents at a land border, preclearance or port of entry with a passport and the file, and no visa is issued. The employment must be temporary in nature even though it may be extended, so an offer described as permanent should be reworded to reflect a defined period. A destination-state licence may still be required before work begins, but an Ontario provincial licence can satisfy the Appendix 2 credential rule.
Sources reviewed 2026-09-07. This guide covers a preparation focus; it is not an individual eligibility assessment.