Licensing Applications

• Abortion Clinic (pdf)
• Adult Day Care Facility (pdf)
• Ambulatory Surgical Facility (pdf)
• Birthing Center (pdf)
• Body Piercing Facility (pdf)
• Community Residential Care Facility (pdf)
• Freestanding or Mobile Technology (pdf)
• Hearing Aid Specialist:
  • Application for Examination (pdf)
  • Application for License (pdf)
  • Application for Temporary Permit (pdf)
• Home Health Agency (pdf)
• Hospice:
  • Hospice Facility (Inpatient) (pdf)
  • Hospice Program (Outpatient) (pdf)
• Hospital or Institutional General Infirmary (pdf)
• Immediate Care Facility for Persons with Intellectual Disability (pdf)
• In-Home Care Provider (pdf)
• Midwifery:
  • Licensed Midwives (pdf)
  • Midwife Apprentice (pdf)
• Nursing Home (pdf)
• Renal Dialysis Facility (pdf)
• Residential Treatment Facility for Children and Adolescents (pdf)
• Chemically Dependent or Addicted Persons Treatment Facility:
  • Outpatient Facility or Narcotic Treatment Program (Outpatient) (pdf)
  • Residential Treatment Program Facility, Medical Detoxification Facility, or Social Detoxification Facility (Inpatient) (pdf)
• Tattoo Facility (pdf)

Other Forms

• Hospital Perinatal Information (pdf)
• Freedom of Information Request (pdf)
• Request for Consideration of Cited Violation (pdf)
• Request for Consultation/Assistance (pdf)
• Request for Exception to Licensing Standard (pdf)