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 State Form 55444?
A: State Form 55444 is a form used in Indiana.
Q: What is the purpose of State Form 55444?
A: State Form 55444 is used to request a change of Administrator or Director of Nursing in Indiana.
Q: Who can use State Form 55444?
A: Facilities in Indiana that need to change their Administrator or Director of Nursing can use State Form 55444.
Q: Are there any fees associated with State Form 55444?
A: No, there are no fees associated with State Form 55444.
Q: Is State Form 55444 specific to Indiana?
A: Yes, State Form 55444 is specific to Indiana.
Q: What information is required on State Form 55444?
A: State Form 55444 requires information about the facility, new Administrator or Director of Nursing, and the effective date of the change.
Q: Are there any deadlines for submitting State Form 55444?
A: There are no specific deadlines mentioned for submitting State Form 55444, but it is recommended to submit the form in a timely manner before the change occurs.
Q: Who should I contact for assistance with State Form 55444?
A: For assistance with State Form 55444, you can contact the Indiana State Department of Health or your local health department.
Form Details:
Download a fillable version of State Form 55444 by clicking the link below or browse more documents and templates provided by the Indiana State Department of Health.