Application for Basic Care
Applications and Fees
Credit card payment must be remitted at time of application submission.
License Fee Schedule
|License Fee||$ 10.00/per bed|
Application Form Signature
There will only be 1 required signature on the application.
Please have a floor plan ready to be uploaded into the application as this is required.
Application Approval Process
Once you have submitted the application, it will be sent for approval. Once the application has been reviewed and approved, the contact for the facility will receive an email letting them know it has been approved. The facility may then go to the website and print a license.