Form DOH-3777 Application for New Service, Expansion of Primary Operating Territory or Transfer of Ownership - New York

Form DOH-3777 Application for New Service, Expansion of Primary Operating Territory or Transfer of Ownership - New York

What Is Form DOH-3777?

This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of Form DOH-3777?
A: The purpose of Form DOH-3777 is to apply for new service, expansion of primary operating territory, or transfer of ownership in New York.

Q: What information is required on Form DOH-3777?
A: Form DOH-3777 requires information about the applicant, the type of service being requested, and details about the proposed service or transfer.

Q: Who needs to complete Form DOH-3777?
A: Any individual or organization planning to apply for new service, expand their primary operating territory, or transfer ownership in New York needs to complete Form DOH-3777.

Q: Are there any fees associated with submitting Form DOH-3777?
A: Yes, there may be fees associated with submitting Form DOH-3777. The specific fees will depend on the type of service or transfer being requested.

Q: What is the processing time for Form DOH-3777?
A: The processing time for Form DOH-3777 varies and can take several weeks. It is recommended to submit the form well in advance of the desired effective date.

Q: Are there any additional documents required with Form DOH-3777?
A: Yes, additional documents may be required depending on the type of service or transfer being requested. It is important to review the instructions and requirements provided with the application.

Q: Who should I contact for assistance with Form DOH-3777?
A: For assistance with Form DOH-3777, you can contact the New York State Department of Health's Bureau of Program Implementation and Enrollment at the provided contact information.

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Form Details:

  • Released on December 1, 2016;
  • The latest edition provided by the New York State Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form DOH-3777 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.

Download Form DOH-3777 Application for New Service, Expansion of Primary Operating Territory or Transfer of Ownership - New York

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