License Forms and Applications

Home Health | Hospice | Hospital | Nursing Home | Outpatient Surgical

Home Health Forms & Applications

Renewal Forms for Home Care Organization Licensure

Instructions for Completing the Renewal Form
Renewal Form

Initial Forms for Home Care Organization Licensure

Licensure Application

Other Forms

Local Zoning Ordinances for Home Care Organization Letter
Surety Bond Requirements for Home Care
Certified Home Health Agency Branch Request
VDH Memo on Criminal Records - Employment Barrier Crimes

Hospice License Forms & Applications

Application for License Renewal
Application for Initial License

Hospital License Forms & Applications

Initial/Renewal/Change Hospital License Application

Nursing Home License Forms & Applications

Nursing Home Renewal Application

Nursing Home Initital or Mid-Year License Application

Outpatient Surgical Hospital License Applications

Outpatient Surgical Hospital License Application

Outpatient Surgical Hospital Initial or Chance License Application