Ariz. Admin. Code § R6-6-1504.04 - Contents of a Complete Application Package - Renewal Certificate

Current through Register Vol. 27, No. 52, December 24, 2021

A renewal application is complete when the Division has all the following information:

1. From the applicant, the following items:
a. AHCCCS provider registration form;
b. Documentation of current CPR and First Aid training, current driver's license, and applicable professional licenses and certifications, if prior documentation has expired;
c. A completed declaration of criminal history every three years since the date of initial certification; and
d. Documentation that fingerprints have been taken at three-year intervals.
2. From sources other than the applicant, documentation that the applicant's home or office has passed a fire inspection every two years since the date of initial certification.


Ariz. Admin. Code § R6-6-1504.04
Adopted effective February 1, 1998 (Supp. 98-1).

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