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Home Care Administrator Registry Forms, Fact Sheets and Information

HCA Preparedness Test Sites
Preparedness Programs

HCA CEU Information (8K)
Resource Material

OSBI Criminal History Information Request

Rules and Law
Home Care Administrator Certification Rules, Chapter 664 (101K)

Home Care Act
    **NOTICE: Click here to view Home Care Act amendments effective November 1, 2011.

Forms and Applications
Home Care Administrator Registry Complaint, ODH Form 612 (13K)
Home Care Administrator Certificate Renewal, ODH Form 770 (8K )

Application for Home Care Administrator Preparedness Program, ODH Form 771 (18K)
Application for Home Care Administrator Provisional Certificate, ODH Form 772 (47K)
Home Care Administrator Certificate Application by Completion of the OHCAPA, ODH Form 773 (45K)
Home Care Administrator Application for Deemed Status, ODH Form 775 (44K)
Request for Duplicate Certificate/Rules and Regulations, ODH Form 715 (107K)


Legal Resident Affidavits
Affidavit of Lawful Presence by Person Making Application for a License, Permit or Certificate, ODH Form 301 (38K)


Contact Information
John W. Judge, Jr., Director
Managed Care Systems
Health Resources Development Service
1000 N.E. 10th Street, Room 1011
Oklahoma City, OK 73117
Main  405.271.6868
Direct  405.271.9444, extension 57273
Fax  405.271.7360
E-mail   JohnWJ@health.ok.gov or



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