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Healthcare Facility Forms

All files are in .PDF format. The free Adobe Acrobat Viewer is required to view them.

Form # Form Name Revision
Date
HEA5134 Health Care Facility Initial License Application 6/06
HEA5135 Health Care Facility Amended License Application 3/02

Last Updated: 9/12/11

Health Care Facility (Imaging/Radiation Therapy Centers) / Radiation Protection 

    
 
 
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Ohio Department of Health, 246 N. High St., Columbus, Ohio 43215