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

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.

Notes

Ariz. Admin. Code § R6-6-1504.04

Adopted effective February 1, 1998 (Supp. 98-1).