Form HCA58-005 Practitioner Endorsement Registration Form - Washington

Form HCA58-005 Practitioner Endorsement Registration Form - Washington

What Is Form HCA58-005?

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

FAQ

Q: What is Form HCA58-005?
A: Form HCA58-005 is the Practitioner Endorsement Registration Form.

Q: What is the purpose of Form HCA58-005?
A: The purpose of Form HCA58-005 is to register practitioners for endorsement in the state of Washington.

Q: Who needs to fill out Form HCA58-005?
A: Practitioners who wish to obtain endorsement in Washington need to fill out Form HCA58-005.

Q: What information is required on Form HCA58-005?
A: Form HCA58-005 requires information such as personal details, education and training, work history, and references.

Q: What happens after I submit Form HCA58-005?
A: Once Form HCA58-005 is submitted, it will be reviewed by the Washington State Department of Health. If approved, the practitioner will receive their endorsement.

Q: Can I track the status of my Form HCA58-005?
A: Yes, you can track the status of your Form HCA58-005 by contacting the Washington State Department of Health.

Q: Is Form HCA58-005 only for practitioners in Washington?
A: Yes, Form HCA58-005 is specifically for practitioners seeking endorsement in the state of Washington.

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Form Details:

  • Released on October 1, 2013;
  • The latest edition provided by the Washington State Health Care Authority;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form HCA58-005 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.

Download Form HCA58-005 Practitioner Endorsement Registration Form - Washington

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