REGULATIONS
Vol. 37 Iss. 19 - May 10, 2021

TITLE 12. HEALTH
DEPARTMENT OF HEALTH
Chapter 381
Forms

NOTICE: The following forms used in administering the regulation have been filed by the agency. Amended or added forms are reflected in the listing and are published following the listing. Online users of this issue of the Virginia Register of Regulations may also click on the name to access a form. The forms are also available from the agency contact or may be viewed at the Office of Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Title of Regulation: 12VAC5-381. Regulations for the Licensure of Home Care Organizations.

Agency Contact: Rebekah E. Allen, Senior Policy Analyst, Virginia Department of Health, 9960 Mayland Drive, Suite 401, Richmond, VA 23233, telephone (804) 367-2102, FAX (804) 527-4502, or email regulatorycomment@vdh.virginia.gov.

FORMS (12VAC5-381)

Application for Home Care Organization Licensure (rev. 2/2021)

Application for Home Care Organization Licensure (rev. 4/2021)

Renewal Addendum for Licenses Expiring July 31, 2021 (eff. 4/2021)

VA.R. Doc. No. R21-6758; Filed April 21, 2021