This is a legal form that was released by the Indiana State Department of Health - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 1714?
A: Form 1714 is the application for renewal of a health facility license in Indiana.
Q: Who needs to file Form 1714?
A: Health facilities in Indiana need to file Form 1714 for renewal of their license.
Q: What information is required on Form 1714?
A: Form 1714 requires information about the health facility, its operations, staffing, and compliance with regulations.
Q: When is Form 1714 due?
A: Form 1714 is usually due 60 days before the current license expires.
Q: Are there any fees to submit Form 1714?
A: Yes, there is a fee associated with submitting Form 1714. The fee amount may vary.
Q: What happens if Form 1714 is not submitted on time?
A: Failure to submit Form 1714 on time may result in the expiration of the health facility's license.
Form Details:
Download a fillable version of State Form 1714 by clicking the link below or browse more documents and templates provided by the Indiana State Department of Health.