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Home Services Division's Licensure Applications and Forms:

Home Care License Application Packets*New!*

Home Care Renewal Packet 2015 (615k.zip)

Companion Sitter Initial Licensing Packet (381k.zip)

Home Care Initial Licensing Packet (2.4k.zip)

Home Care Prorated Licensing Packet (59.9k.zip)

Home Care Application Forms:

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

ODH-757 Application for License to Operate a Home Care Agency. (67.6k.pdf) 

ODH-758 Application for Initial License to Operate a Home Care Agency Branch. (33.29k.pdf)

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

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

Hospice License Application Packets*New!* 

Hospice Renewal Packet 2015, (5.79k.zip)

Hospice Initial Licensing Packet, (2.21mb.zip)

Hospice Application Forms:

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

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

Mailing Address: 

OSDH - Medical Facilities Service
Attn:
Home Services Division
1000 NE 10th Street
Oklahoma City, OK 73117-1299

Telephone: 405-271-6576
Fax: 405-271-1141

Email: medicalfacilities@health.ok.gov

 


Special Announcements
All licensing fees must accompany the completed application form and be mailed to the following address: Financial Management-Receipting Unit, OSDH, PO Box 268823, Oklahoma City, OK 73126-8816, Failure to do so may result in a delay in the processing of your license application.


Frequently Asked Questions
Q: What is the purpose of the initial licensure on-site survey?
A: To determine if your agency meets the minimum requirements to receive a home care license. Failure to comply with all requirements will result in a denial of the application. Your agency must be ready for business at the time of the initial survey. All on-site surveys are pass or fail. All forms, documents, applications, policies, etc. must be complete & available at the time of the survey.


Related Topics
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