Form DR361 Health Care Provider Application - California

Form DR361 Health Care Provider Application - California

What Is Form DR361?

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

FAQ

Q: What is the Form DR361?
A: Form DR361 is the Health Care Provider Application in California.

Q: Who needs to fill out the Form DR361?
A: Health care providers in California need to fill out the Form DR361.

Q: What is the purpose of the Form DR361?
A: The purpose of the Form DR361 is to apply to become a health care provider in California.

Q: Is there a fee to submit the Form DR361?
A: Yes, there is a fee associated with submitting the Form DR361.

Q: What information is required on the Form DR361?
A: The Form DR361 requires information about the health care provider's background, qualifications, and contact information.

Q: Is the Form DR361 specific to a certain type of health care provider?
A: No, the Form DR361 is applicable to all health care providers in California.

Q: Are there any supporting documents required with the Form DR361?
A: Yes, supporting documents such as proof of licensure or certification may be required to accompany the Form DR361.

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Form Details:

  • Released on September 1, 2012;
  • The latest edition provided by the California Department of Rehabilitation;
  • 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 fillable version of Form DR361 by clicking the link below or browse more documents and templates provided by the California Department of Rehabilitation.

Download Form DR361 Health Care Provider Application - California

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