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License Filing *NOTICE * THIS FORM WAS REVISED IN JUNE 2015 PLEASE READ CAREFULLY THIS FILING IS REQUIRED FOR ALL HEALTHCARE FACILITIES THAT MUST SUBMIT TO ARCHITECTURAL REVIEW AND MUST BE SUBMITTED
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This form was revised to ensure accuracy and compliance with current regulations.
All individuals or entities who meet the criteria set forth in the revised form are required to file.
The revised form must be filled out completely and accurately according to the instructions provided.
The purpose of the revised form is to gather specific information required by the regulatory authorities.
The revised form requires reporting of relevant financial and personal information as specified in the instructions.
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