Reference: Ref-04947

Reference Name: Medical/Clinic Director Attestation, AHCA Form 3110-1028 (Sept 2014)
Agency: 59 Agency for Health Care Administration
59A Health Facility and Agency Licensing

Original Document(s):
1/7/2015 Medical/Clinic Director Attestation of Legal Responsibility for a clinic's activities.
Modified Document(s): No Modified document(s).
Description: Medical/Clinic Director Attestation of Legal Responsibility for a clinic's activities.
Rules/Notices using this Reference Material
Notice /
Adopted
Section Description ID Publish
Date
View Text Final
59A-33.002
Licensure, Application Process, General Requirements 15589954 Effective:
02/12/2015