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Electronic Letter of Intent: Request for a Colorado Health Facility/Agency
License Application and/or Certification Packet
Monday, August 03, 2015 3:17 PM

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Submission of this request in no way obligates the requestor or applicant to open a health facility/agency. The information does allow the Division to track the number of proposed facilities, efficiently handle application requests and to eliminate unnecessary mailings of information packets. Please provide the requested information to the best of your knowledge. If a question is not applicable or is unknown at the time of request, please write “N/A” or “Unknown” where appropriate. Thank you for your inquiry.

Select the facility/agency type below you wish to apply for and click on the continue button.

Facility/Agency Types:

Contact Information:

Electronic Letter of Intent Questions Email:
Licensing Questions Email:
Licensure Customer Assistance Line at (303) 692-2836