Applications and renewals
Forms for Applying for a new license.
Note: To save time, please reach out to [email protected] prior to completing any forms.
Different facilities have different requirements and she can assist with the process.
If an architectural plan review is required for new construction:
- Submit a notice of intent by completing the Health Facility Application
- Under “Purpose” select “This is New Construction”
- Apply and submit all of the following:
- Provide the name and contact information for each responsible decision-maker, including any owner or program or facility administrator.
- Administrator Qualifications
- A copy of your current city business license
- A copy of your current fire inspection
- A copy of your kitchen inspection
- Certificate of Occupancy
- Zoning
- Visitation Policy (Must be submitted for End Stage Renal Disease Center, Ambulatory Surgical Facilities, Hospitals, Assisted Living Facilities, Birthing Centers, and Abortion Clinics)
- Construction Approval (Must be submitted for End Stage Renal Disease Center, Ambulatory Surgical Facilities, Hospitals, Assisted Living Facilities, Birthing Centers, and Abortion Clinics)
No sooner than 4 working days after submitting the application:
- Pay required fees
- Create a UtahId Login
- Log Into your Office of Licensing Portal
Background screenings should be completed in the Direct Access Clearance System (DACS) for all staff who will have direct or incidental contact with clients or their records. New programs will be given access to DACS after submitting a license application.
More information on the process of background screenings can be found on the Office of Background Processing page.
Applying for a new mammography certification
- Apply and submit all of the following:
- Provide the name and contact information for each responsible decision-maker, including any owner or program or facility administrator.
- Medical Health Physicist Certificate
- ACR Accreditation
- FDA Approval
- DEQ Approval
No sooner than 4 working days after submitting the application:
- Pay required fees
- Create a UtahId Login
- Log Into your Office of Licensing Portal
Renewing a license or certificate
In order to renew your license, you must submit all required items no later than 30 days before your license expires. Failure to submit a full renewal request, pay the required fees, and show compliance with the licensing rules may result in late fees or the need to reapply for a new license.
- Fill out and submit a Renewal Request via your Office of Licensing Provider Portal. Upload the below information into the Renewal Request:
- Provide the name and contact information for each responsible decision-maker, including any owner or program or facility administrator.
- A copy of your current fire inspection
- Pay the appropriate fees.
- When all requirements have been submitted and all criteria have been met, your renewed license will be sent to you by a Process Specialist.
- Fill out and submit a Renewal Request via your Office of Licensing Provider Portal. Upload the below information into the Renewal Request:
- Provide the name and contact information for each responsible decision-maker, including any owner or program or facility administrator.
- Medical Health Physicist Certificate
- ACR Accreditation
- FDA Approval
- Pay the appropriate fees.
- When all requirements have been submitted and all criteria have been met, your renewed license will be sent to you by a Process Specialist.
Changes to a license or certificate
- To make any of the following changes, a new application must be submitted. Follow the instructions for “Applying for a new license” above.
- A change of location
- A change in the population served
- A change in the regulation type of the program or facility
- A change that transfers 50% or more ownership or controlling interest to a new owner
- To request any of the following changes, submit a Change Request through your Office of Licensing Portal
- Administrator Changes
- Increase or decrease in your licensed capacity
- Change of facility name
- Less than 50% of Ownership Change
- Change in phone number or email address
- Change of Management Company
- Supervising Physician Changes (Mammography Only)