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Download Forms for Facilities

IMPORTANT! - Registrants should allow a MINIMUM OF TWO WEEKS from date of receipt for your license/permit application to be processed. PLEASE DO NOT CALL THE BOARD OFFICE BEFORE THE 2 WEEK PERIOD IS COMPLETED.

Renewal applications for the 2015-2016 renewal period:

Applications for NEW permits or CHANGE of Name, Ownership or Location:

Each new application or application for change of Name, Ownership or Location must also have one of the following forms attached, please choose your type of ownership and attach the appropriate form:

  • Form A - Sole Proprietor or Partnership
  • Form B-1 - Corporation (not publicly traded)
  • Form B-2 - Corporation (publicly traded)
  • Form C - Limited Liability Company
  • Form D - Government
Licenses are non-transferable! A new application is required for any change of owner, change of location or change of name.




Last Modified on 10/12/2015
Frequently Asked Questions

Q: If there is a change in my information what are the requirements?
A: Permits are non-transferable. A change of name, owner, and/or location requires a new application. See the rule for change requirements below under Related Topics.

Interesting Facts

  • "DISTRIBUTOR" - a business that may sell medical gases on drug orders issued to patients and to medical gas suppliers or other entities licensed to use, administer, or distribute medical gases.
  • "SUPPLIER" - a business that may sell medical gases only on drug orders issued to a patient.
Related Topics