Division of Licensing Services
Long-Term Care Facilities Licensing Forms
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.
- Long-Term Care Facilities Licensing: Initial Application | Renewal Application
- Remittance Form (NOTE: This form is required with both the initial and renewal applications.)
- Nutrition and Feeding Assistance Training Program Application Form
- Healthcare Institution Approval for Architectural Plans and Specification Form
- Credit Card Payment Form and Instructions
- Frequently Asked Questions (FAQs)