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Facility Services Division Licensure Applications and Related Forms:

Hospital Applications and Forms:

ODH-920 Application for License to Operate a Hospital (22k.pdf)

ODH-892 Board of Directors Information Sheet (11k.pdf)

ODH-911 Hospital Emergency Medical Services Classification Report (13k.pdf)

ODH-928 Life Safety Code Inspection Report for Hospitals (28k.pdf)

ODH-929 Hospital Designation of Licensed Beds (11k.pdf)

Ambulatory Surgical Centers Applications and Forms:

ODH-909 Application for License to Operate an Ambulatory Surgical Center

Workplace Drug & Alcohol Testing Facilities Applications and Forms:

ODH-912 Drug and Alcohol Testing Facility Application (28k.pdf)

Workplace Drug and Alcohol Application Checklist 

Birthing Center Applications and Forms:

ODH-920 Application for License to Operate a Hospital (22k.pdf)

Tissue and Eye Banks - Anatomical Gifts Application and Forms:

ODH-756 Application for Permit to operate a Tissue Bank or Eye Bank (111k.pdf)

ODH-942 Certificate of Request for Anatomical Gift (49k.pdf) (obsolete)

Abortion Facilities Applications and Forms:

ODH-777 Application for License to Operate an Abortion Facility (21k.pdf)

ODH-779 Operational Program Narrative Update 

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-Facility Services Division
1000 NE 10th Street
Oklahoma City, OK 73117-1299

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.

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