This is a legal form that was released by the Illinois Department of Public Health - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 482-0677?
A: Form 482-0677 is the Freestanding Emergency Center (FEC) Renewal Licensure Application for Illinois.
Q: What is a Freestanding Emergency Center (FEC)?
A: A Freestanding Emergency Center (FEC) is a facility that provides emergency medical services outside of a hospital setting.
Q: Who needs to fill out Form 482-0677?
A: Facilities in Illinois that are currently licensed as Freestanding Emergency Centers and need to renew their license must fill out this form.
Q: What is the purpose of Form 482-0677?
A: The purpose of this form is to renew the licensure of a Freestanding Emergency Center in Illinois.
Q: Are there any fees associated with Form 482-0677?
A: Yes, there are fees associated with the renewal licensure application for a Freestanding Emergency Center in Illinois. The fee amount may vary.
Q: What documents or information do I need to fill out Form 482-0677?
A: You will need to provide information such as the facility's name, address, contact information, license number, and any changes to the facility's operations or services.
Q: What is the deadline for submitting Form 482-0677?
A: The specific deadline for submitting the renewal licensure application may vary. It is recommended to check the instructions on the form or contact the Illinois Department of Public Health for the deadline.
Q: Who can I contact for more information about Form 482-0677?
A: For more information about Form 482-0677 or the renewal licensure process for Freestanding Emergency Centers in Illinois, you can contact the Illinois Department of Public Health.
Form Details:
Download a fillable version of Form 482-0677 by clicking the link below or browse more documents and templates provided by the Illinois Department of Public Health.