Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin

Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin

What Is Form F-00191?

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

FAQ

Q: What is Form F-00191?A: Form F-00191 is a request form for a branch office of a certified outpatient clinic in Wisconsin.

Q: What is a certified outpatient clinic?A: A certified outpatient clinic is a healthcare facility that provides medical services to patients on an outpatient basis.

Q: What is a branch office?A: A branch office is an additional location of a certified outpatient clinic.

Q: Why do I need to request a branch office?A: You need to request a branch office to expand the services of your certified outpatient clinic to another location.

Q: What information do I need to provide on Form F-00191?A: You need to provide information about your certified outpatient clinic, the proposed branch office location, and the services it will provide.

Q: How long does it take to process the request for a branch office?A: The processing time for a request for a branch office can vary. It is recommended to contact the Wisconsin Department of Health Services for more information.

Q: Can I operate a branch office without approval?A: No, you must receive approval from the Wisconsin Department of Health Services before operating a branch office.

Q: What happens after I submit Form F-00191?A: After you submit Form F-00191, it will be reviewed by the Wisconsin Department of Health Services. They will notify you of the approval or denial of your request.

ADVERTISEMENT

Form Details:

  • Released on June 1, 2019;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form F-00191 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin

4.5 of 5 (19 votes)
  • Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin

    1

  • Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin, Page 2

    2

  • Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin, Page 1
  • Form F-00191 Certified Outpatient Clinic - Request for a Branch Office - Wisconsin, Page 2
Prev 1 2 Next
ADVERTISEMENT