Get Ohio Department Of Health Maternity Licensure Application Form
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How to fill out the Ohio Department Of Health Maternity Licensure Application Form online
Navigating the Ohio Department of Health Maternity Licensure Application Form can seem complex, but this guide will provide you with clear, step-by-step instructions to complete the form online. Whether you are applying for the first time or renewing your license, this overview will support you in the process.
Follow the steps to successfully complete your application.
- Click the ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by selecting the 'Application Type' you are applying for, either 'Initial' or 'Renewal'. Be sure to check the appropriate box.
- Indicate the level of care services you are applying for by checking the corresponding box: Level I, Level II, Level III, Sub Level II, Sub Level III, or for a Freestanding Children's Hospital.
- Fill in the 'Hospital/Home Name', 'Address', 'City', 'County', 'State', and 'Zip' fields accurately to ensure proper identification.
- Provide the 'Telephone Number' and 'E-mail Address' of the unit or home contact person to facilitate communication.
- Complete the 'Capacity/Floor Location' section by specifying the obstetrical and neonatal care capacities along with their respective floor locations.
- Identify the 'Name of Local Health Department with Jurisdiction' that oversees your facility.
- Read and affirm the certification statement regarding adherence to the provisions of the Ohio Revised Code by signing and dating at the bottom. Ensure that the 'Print/Type Authorized Representative Name' field is completed as well.
- Once all sections are filled out correctly, review your application for accuracy. Save your changes and make sure to download a copy for your records.
- Submit the completed form along with the nonrefundable application fee to the designated address listed in the instructions. Ensure you have the appropriate amount ready based on the service level selected.
Start filling out your Ohio Department of Health Maternity Licensure Application Form online today!
You should send your transcripts directly to the Ohio Board of Nursing for processing. Make sure to obtain official copies from your educational institution. This step is crucial for the Ohio Department Of Health Maternity Licensure Application Form because the Board requires your credentials to verify your qualifications. For convenience, consider using the US Legal platform to navigate these requirements smoothly.
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