Application Fees
A.R.S. § 36-405(B)(5) requires the Department to collect nonrefundable application and licensing fees from all health care institutions. All health care institution license applications must include a $50 nonrefundable application fee. The Department will consider any application received without the application fee to be incomplete. Checks shall be made payable to the Arizona Department of Health Services.
- Initial License Application for Residential Health Care Institutions (NOTE: This application has been updated, effective May 1, 2022. Older versions of the application will not be accepted after May 15, 2022.)
- Arizona Statement of Citizenship and Alien Status (Note: This form is required for applicants that are sole proprietors or a partnership.)
- Architecture Attestation
- Residential Health Care Institution Modification Application
Additional Resources
- Assisted Living Home Initial Checklist
- Assisted Living Center Initial Checklist
- Adult Foster Care Home Initial Checklist
- Adult Day Health Care Facility Initial Checklist
- Remittance Form (NOTE: This form can be used to calculate your licensing fees.)
- Licensing Fee Payment Reminder
- Applicant Frequently Asked Questions