This version of the form is not currently in use and is provided for reference only. Download this version of Form HEA5523 for the current year.
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.
Form Details:
Download a fillable version of Form HEA5523 by clicking the link below or browse more documents and templates provided by the Ohio Department of Health.