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Home Services Division's Licensure Applications and Forms:


Application Guidance Letters:

Home Care Application Guidance


Home Care Application Forms:

ODH-1273 Application for License to Operate a Sitter or Companion Service Agency. (56k.pdf)

ODH-757 Application for License to Operate a Home Care Agency. (67.6k.pdf)

ODH-758 Application for Initial Home Care Branch

Hospice Application Forms:

ODH-924 Application for License to operate a Hospice. (56k.pdf)

ODH-659 Application for Hospice Alternative Administrative Office. (50k.pdf)

CMS (The Centers for Medicare & Medicaid Services) Forms:

CMS Forms for Home Health 2017

CMS Forms for Hospice 2017

Contact Us: 

OSDH - Medical Facilities Service
Attn: Home Services Division
1000 NE 10th Street
Oklahoma City, OK 73117-1299

Telephone: 405-271-6576
Fax: 405-271-1141

Email: medicalfacilities@health.ok.gov

Special Announcements
 
All licensing fees must accompany the completed application form and be mailed to the following address: Financial Management-Receipting Unit, OSDH, PO Box 268823, Oklahoma City, OK 73126-8816, Failure to do so may result in a delay in the processing of your license application.

Frequently Asked Questions

Q: What if my application is incomplete?
A: The Home Services Division will work with you in order to facilitate a complete application. If the application is not complete and fails to meet all requirements for an initial survey, your application may be summarily dismissed.

Q: What is the purpose of the initial licensure on-site survey?
A: To determine if an agency meets the minimum requirements to receive a home care/ hospice or Companion Sitter license.

Q: What does it mean to have deficiencies cited at the initial licensure on-site survey?
A: A deficiency means that a minimum requirement was not met, and the agency would receive a written statement of deficiency report. The agency must provide a written plan of correction for review, in response to each cited deficiency.

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