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State Form 1714 Application for Renewal of Health Facility License - Indiana
What Is State Form 1714?
This is a legal form that was released by the Indiana State Department of Health - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 1714?A: Form 1714 is the application for renewal of a health facility license in Indiana.
Q: Who needs to file Form 1714?A: Health facilities in Indiana need to file Form 1714 for renewal of their license.
Q: What information is required on Form 1714?A: Form 1714 requires information about the health facility, its operations, staffing, and compliance with regulations.
Q: When is Form 1714 due?A: Form 1714 is usually due 60 days before the current license expires.
Q: Are there any fees to submit Form 1714?A: Yes, there is a fee associated with submitting Form 1714. The fee amount may vary.
Q: What happens if Form 1714 is not submitted on time?A: Failure to submit Form 1714 on time may result in the expiration of the health facility's license.
Form Details:
- Released on December 1, 2019;
- The latest edition provided by the Indiana State Department of Health;
- 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 fillable version of State Form 1714 by clicking the link below or browse more documents and templates provided by the Indiana State Department of Health.
Download State Form 1714 Application for Renewal of Health Facility License - Indiana
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