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.
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.
Form Details:
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.