ADHS Division of Licensing Services
Assisted Living 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.
- Initial License Application Packet
- Renewal License Application Packet
- Architectural Review Application
- Survey Tool
- Initial Survey Checklist
- Credit Card Payment Form and Instructions
- Training Program Initial Application
- Training Program Renewal Application
- Fingerprinting FAQs
- Fingerprint Substantive Policy
For a Change of Ownership Application, please contact the Office of Assisted Living by phone or in writing.
Information provided in PDF files, unless otherwise indicated.