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Get the free Facility Status Changes Form - Arizona Department of Health Services - azdhs

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Please make the necessary changes on this form and fax to our offices so that your renewal bill is sent to the correct address and the correct information is on the next certificate. FACILITY STATUS
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The facility status changes form is a document used to report any changes in the status of a facility, such as changes in ownership, location, or operational activities.
Any individual, organization, or entity that experiences changes in the status of a facility is required to file the facility status changes form.
To fill out the facility status changes form, you need to provide accurate and up-to-date information regarding the changes in the facility's status. This may include details about ownership, address, operations, and other relevant information.
The purpose of the facility status changes form is to ensure that regulatory bodies and government agencies are informed about any significant changes in the status of a facility. This helps in tracking and monitoring operations, compliance, and regulatory requirements.
The facility status changes form typically requires information such as the facility's name, address, previous and current ownership details, nature of changes, effective dates, and any other relevant details specific to the change being reported.
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