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E. ()II/ILLINOIS HEALTH FACILITIES AND SERVICES REVIEW BOARD APPLICATION FOR EXEMPTION FOR THE CHANGE OF OWNERSHIP MORAN EXISTING HEALTH CARE FACILITY 1.INFORMATION FOR EXISTING FACILITY SEP 1 5 2015HEALTH
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Gather all the necessary information and documents required for the form.
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Start by providing your personal details such as name, address, and contact information.
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Next, fill in the details about the health facility you are associated with, including its name, address, and contact information.
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Proceed to provide information about the type of facility, the services it offers, and the number of beds available.
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This includes but is not limited to hospitals, clinics, nursing homes, rehabilitation centers, and other healthcare institutions.
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It is essential for these facilities to fill out this form to ensure compliance with state regulations and to be officially recognized as a licensed health facility in the state of Illinois.
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By completing this form, health facilities can demonstrate their commitment to providing quality healthcare services and ensuring the safety and well-being of their patients.
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ii-illinois health facilities and is a specific form used in Illinois to report information about health facilities.
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Information such as facility name, address, services provided, number of patients treated, and staffing levels must be reported on ii-illinois health facilities and.
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