ADHS Division of Licensing Services

Behavioral Health Facilities License Application Forms

Notice Regarding Application Fees:

A.R.S. § 36-405(C)(1) requires the Department to collect nonrefundable application fees from all health care institutions. All Initial, Renewal, and Change of Ownership applications must include a $50 nonrefundable application fee. The Department will consider any application received without the application fee to be incomplete.  (Note: This does not apply to Child Care Licensing.) Checks shall be made payable to the Arizona Department of Health Services.

NOTE: All applications require an Arizona Statement of Citizenship and Alien Status.

• Initial Licensure Application Form
• Application Fee Remittance Form
• Renewal License Application
• General Instructions for Behavioral Health Licensure Application
• Application Letter
• Criminal History Affidavit
• Program Description Check List
• Notice of Readiness
• Program Description
• Resource List
• Credit Card Payment Form and Instructions

Information provided in PDF files, unless otherwise indicated.