Did I ruin my chances?

I sent in an application for my 1st ever RN job at a local Hospital.Under previous work experience I listed a bed side nurse position i had as a teen im now 31.I have worked at 2 other nursing homes since then but decided not to list them as i wasn't there for very long and i didn't want it to look as though i have never worked a day since i finished school.At the interview i was requested to fill out a form which they will be sending to this employer kindda an evaluation sheet of my work performance while there etc.Problem is me and this employer didnt end on the best of terms.I'm so scared i will be given a horrible review and ruin any chance i have of landing this job.If i knew about those forms before hand i never would have listed any employment on my application.Any Advice Please?
I would doubt very much that after 10+ years there will be little information on file other than the fact that you worked there.What exactly do you think they are going to say? It's not likely even the same staff any more.Just out of curiosity, what kind of bedside nursing could you do as a teenager?If this was before school you wouldn't have been a nurse yet.

Personal clashes Vs professionalism....if you were efficient and good at your job then you should have nothing to fear except fear itself.

I had completed a 3 month bedside nurse programme and that was my first ever job

Sounds like a CNA or tech position. Please be careful, they may mistakenly think you have nursing experience as in RN or LPN because of the "bedside nurse program" and what you put on the application. After so many years, I doubt anything negative will be said.

thanks for the replies keeping my fingers crossed.