Form HEA5134 Health Care Facility Initial License Application - Ohio

Form HEA5134 Health Care Facility Initial License Application - Ohio

What Is Form HEA5134?

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

FAQ

Q: What is the purpose of form HEA5134?
A: Form HEA5134 is used to apply for an initial license for a health care facility in Ohio.

Q: What information is required on form HEA5134?
A: Form HEA5134 requires various information about the health care facility, including its name, address, and legal structure.

Q: Who needs to complete form HEA5134?
A: Any person or organization that wants to open a health care facility in Ohio must complete form HEA5134.

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Form Details:

  • Released on June 1, 2013;
  • The latest edition provided by the Ohio Department of Health;
  • 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 HEA5134 by clicking the link below or browse more documents and templates provided by the Ohio Department of Health.

Download Form HEA5134 Health Care Facility Initial License Application - Ohio

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