Arizona Department of Health Services Forms

This document is used for renewing the license of a health care institution in the state of Arizona.

This Form is used for requesting the employer status in the state of Arizona.

This document is a proficiency measurement tool used in Arizona for assessing the facilitation skills of Child and Family Teams.

This form is used for a checklist to ensure proper training of new staff members in Arizona.

This type of document is used for reporting incidents, accidents, and deaths in Arizona.

This document is used for emergency preparedness and contains important information and immunization records for residents of Arizona.

This document is used for verifying citizenship and alien status for state licensing or certification in the state of Arizona.

This document is for obtaining a physician's certification for medical marijuana use in Arizona. It is required for individuals who want to use medical marijuana for medical conditions.

This form is used for tracking non-analytic data related to cancer cases in Arizona. It is part of the Arizona Cancer Registry's efforts to collect information on cancer incidence and help in cancer prevention and control.

This document provides new abstractor information for the Arizona Cancer Registry (ACR) in Arizona. It includes important details for individuals involved in abstracting cancer-related data.

This form is used for screening visitors to congregate settings in Arizona where vulnerable adults and children are present. It helps ensure the safety and well-being of these individuals by assessing the visitors' health and potential risk factors.

This document is for qualified patients in the Medical Marijuana Program in Arizona who want to add or replace a caregiver.

This form is used for patients under 18 who are participating in the Medical Marijuana Program in Arizona. It is used to gather information about the patient's medical condition and to provide consent for the use of medical marijuana.

This form is used for laboratory owners to attest their compliance with the Medical Marijuana Program in Arizona.

This document is used to certify that the principal officer and board members of a medical marijuana program in Arizona have met the required qualifications and have abided by the regulations set forth by the state.

This document for attesting the qualifications of a laboratory technical director participating in the medical marijuana program in Arizona.

This form is used for applying to Behavioral Health Respite and Adult Therapeutic Homes in Arizona.

This form is used for requesting certification and transmitting information for behavioral health providers in the state of Arizona.

This document is used for obtaining approval for architectural plans and specifications of a health care institution in the state of Arizona.

This form is used for certifying the small entity status of a business located in Arizona for BRC Form 333 certification purposes.

This Form is used for filing a complaint related to radiation control with the Bureau of Radiation Control in Arizona.

This Form is used for submitting a service registration application in Arizona.

This form is used for principal officers and/or board members to attest their involvement in licensed facility applications for the marijuana program in Arizona.

This document is used for applying for an initial residential health care institution license in the state of Arizona. It is required for healthcare providers who wish to operate a residential facility for the care of individuals in need of medical services.

This form is used for applying for modifications to a residential health care institution in the state of Arizona.

This Form is used for remitting application and license fees in the state of Arizona.

This form is used in Arizona's marijuana program to verify fingerprints for applicants.

This document is for the process of inactivating a service registration in the state of Arizona.

This Form is used for applying for Qualified Expert Approval in Arizona. It is required for individuals who want to become qualified experts in their field.

This document is used for attesting the architecture of health care institution license applications in the state of Arizona. It outlines the necessary requirements and guidelines for ensuring the proper design and structure of these applications.

This document is used for changing the ownership of property in the Medical Marijuana Program in Arizona. It is required for change applications in the program.

This form is used for recording detailed information about a newborn child in the state of Arizona. It constitutes an essential document for registering a live birth and includes fields for parent details, infant details, and birthplace.

This document provides a guide for parents in Arizona on how to identify and manage diaper changes in breastfed babies.

This document is used to track and log the temperature of a VFC refrigerator in Arizona.

This form is used by health professionals in Arizona to record the immunization history of children and adolescents. It safeguards crucial data about administered vaccines and prevents unnecessary repeat immunizations.