Most forms are
downloadable in Microsoft Word (word) or Adobe
Acrobat (pdf) file formats. Download and save
the file to your computer, complete the form,
and mail to the Bureau of Health Care Quality
and Compliance at the address indicated on the
form.
Health Facilities
►Application
for Medical Facilities, Health Facilities, and
other provider types (pdf)
►Checklist
for Medical and Health Facilities (Choose the
checklist for your facility type)
►Sample
Criminal History Statement
(word)
(pdf)
PV
Plan Review
Documents
►Plan
Review Application and Instructions
(word) (pdf)
►Functional Plan Instructions
Ambulatory Surgical Center
(word)
(pdf)
Hospital
(word)
(pdf)
Psychiatric Hospital
(word)
(pdf)
Rehabilitation Hospital
(word)
(pdf)
Skilled Nursing Facility
(word)
(pdf)
►Plan
Review of Food Establishments within Health
Facilities (word)
(pdf)
med
Medical
Laboratories and Personnel
Downloadable Applications
Labs
Personnel
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