ADHS Division of Licensing Services
Medical Facilities License Application Forms
Notice Regarding Application Fees:
A.R.S. § 36-405(C)(1) requires the Department to collect nonrefundable application fees from all health care institutions. All Initial, Renewal, and Change of Ownership applications must include a $50 nonrefundable application fee. The Department will consider any application received without the application fee to be incomplete. (Note: This does not apply to Child Care Licensing.) Checks shall be made payable to the Arizona Department of Health Services.
NOTE: All applications require an Arizona Statement of Citizenship and Alien Status.
- Abortion Clinic Licensing Forms
- Architectural Review Application
- Instructions for Completing HCI Application
- Initial License Application
- Initial License Fee Remittance Form
- Initial License Application Checklist
- Renewal application for Health Care Facility Licensing
- Renewal License Fee Remittance Form
- Renewal Application Checklist
- Application for Single Group Licensing
- Additional Information Needed For Home Health Agency
- Additional Information Needed For Hospice Agency
- Medical Specialties and Subspecialties
- Outpatient Facility Information
- Recovery Care Center Information
- Licensed Capacity
- Zoning Authority Clearance
- Credit Card Payment Form and Instructions
Information provided in PDF files, unless otherwise indicated.