Home Services Division's Licensure Applications and Forms:

Home Care Agency Licensure Applications and Related Forms:

ODH-Pending # Initial application to open a Sitter or Companion Service Agency (56k.pdf)

ODH-757 Initial application to open a Home Care Agency (29k.pdf)

ODH-758 Initial application to open a branch Home Care Agency (15k.pdf)

ODH-759 Application to renew a Home Care Agency license. Effective 08.08 (26k.pdf)

ODH-760 Application for a Home Care Agency Change of Ownership (26k.pdf)

ODH-761 Application for a Home Care Agency pro-rated license renewal (24k.pdf)

ODH-776 Application to amend a Home Care Agency license (15k.pdf)

ODH-780 Application for legal assignment of a license to operate an existing Home Care Agency (25k.pdf)

Hospice Licensure Applications and Related Forms:

ODH-924 Application for License to operate a Hospice. Revised 05/2008 (56k.pdf)

ODH-659 Application for Hospice Alternative Administrative Office (50k.pdf)

Initial licensure packets are now available at no charge.  To order an initial licensure packet for one of the above mentioned licensed facilities please contact our office at the following address:
 
Oklahoma State Department of Health
PHS-Medical Facilities Service-Home Services Division
1000 NE 10th Street
Oklahoma City, OK 73117-1299
Telephone: 405-271-6576
Email: medicalfacilities@health.ok.gov