Get the free CERTIFICATE OF NEED EXTENSION REQUEST - idph state ia
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This document is intended for applicants seeking to extend their current project timeline and provide updates on the status and finances of their healthcare-related projects.
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How to fill out certificate of need extension
How to fill out CERTIFICATE OF NEED EXTENSION REQUEST
01
Obtain the CERTIFICATE OF NEED EXTENSION REQUEST form from the relevant state health department website.
02
Fill in the applicant's details, including name, address, and contact information.
03
Provide the original CERTIFICATE OF NEED number that you are requesting an extension for.
04
Explain the reason for seeking an extension, including any relevant circumstances.
05
Include supporting documentation that demonstrates the need for the extension.
06
Sign and date the request form.
07
Submit the completed form and any documents to the appropriate regulatory office, ensuring you keep a copy for your records.
Who needs CERTIFICATE OF NEED EXTENSION REQUEST?
01
Healthcare providers who have previously received a CERTIFICATE OF NEED and require additional time to complete the approved project.
02
Organizations looking to expand or modify healthcare services that were previously authorized.
03
Entities that encounter unforeseen delays in their planned healthcare projects and need to formally request more time.
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What is CERTIFICATE OF NEED EXTENSION REQUEST?
A Certificate of Need (CON) Extension Request is a formal application submitted to extend the validity period of an existing CON, which is typically required for certain healthcare projects or services.
Who is required to file CERTIFICATE OF NEED EXTENSION REQUEST?
Healthcare providers or organizations that have previously obtained a Certificate of Need and wish to extend its validity must file a CON Extension Request.
How to fill out CERTIFICATE OF NEED EXTENSION REQUEST?
To fill out a CON Extension Request, the applicant must complete the designated application form, providing relevant details such as project information, reason for extension, and any required supporting documentation.
What is the purpose of CERTIFICATE OF NEED EXTENSION REQUEST?
The purpose of a CON Extension Request is to allow healthcare providers additional time to implement their approved projects or services due to unforeseen circumstances or delays.
What information must be reported on CERTIFICATE OF NEED EXTENSION REQUEST?
The information required typically includes the original CON number, project description, justification for the extension, updated timelines, and any changes to the project's scope or funding.
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