Form CDPH611 Licensing and Certification for an Affiliate Primary Care Clinic Application - California

What Is Form CDPH611?

This is a legal form that was released by the California Department of Public Health - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of Form CDPH611?
A: Form CDPH611 is used for licensing and certification of an Affiliate Primary Care Clinic in California.

Q: What is an Affiliate Primary Care Clinic?
A: An Affiliate Primary Care Clinic is a clinic that operates in conjunction with a licensed primary care clinic to provide expanded services.

Q: Who needs to complete Form CDPH611?
A: Any organization or entity that wishes to establish or operate an Affiliate Primary Care Clinic in California needs to complete this form.

Q: What information is required in Form CDPH611?
A: The form requires information about the applicant's organization, the proposed clinic location, services to be provided, personnel, and compliance with regulatory requirements.