Ariz. Admin. Code § R9-10-1902 - Supplemental Application Requirements

In addition to the license application requirements in A.R.S. § 36-422 and 9 A.A.C. 10, Article 1, a governing authority applying for a license as a counseling facility shall submit, in a format provided by the Department:

1. The days and hours of clinical operation and, if different from the days and hours of clinical operation, the days and hours of administrative operation;

2. If applicable, a request to provide one of more of the following:

a. DUI screening,

b. DUI education,

c. DUI treatment, or

d. Misdemeanor domestic violence offender treatment;

3. Whether the counseling facility has an affiliated outpatient treatment center;

4. If the counseling facility has an affiliated outpatient treatment center:

a. The affiliated outpatient treatment center's name; and

b. Either:

i. The license number assigned to the affiliated outpatient treatment center by the Department; or

ii. If the affiliated outpatient treatment center is not currently licensed, the:

(1) Street address of the affiliated outpatient treatment center, and

(2) Date the affiliated outpatient treatment center submitted to the Department an application for a health care institution license;

5. Whether the counseling facility is sharing administrative support with an affiliated counseling facility; and

6. If the counseling facility is sharing administrative support with an affiliated counseling facility, for each affiliated counseling facility sharing administrative support with the counseling facility:

a. The affiliated counseling facility's name; and

b. Either:

i. The license number assigned to the affiliated counseling facility by the Department; or

ii. If the affiliated counseling facility is not currently licensed, the:

(1) Street address of the affiliated counseling facility, and

(2) Date the affiliated counseling facility submitted to the Department an application for a health care institution license.

Notes

Ariz. Admin. Code § R9-10-1902

Adopted by exempt rulemaking at 20 A.A.R. 3535, effective 1/1/2015. Amended by final rulemaking at 25 A.A.R. 1583, effective 10/1/2019.