N.Y. Comp. Codes R. & Regs. tit. 14, Appendices, app 2
Current through Register Vol. 46, No. 43, October 23, 2024
APPLICATION FOR APPROVAL OF GENERAL HOSPITAL PSYCHIATRIC SERVICES
I. Form of Application for Approval of a General Hospital's Psychiatric Service 1. The name of the hospital is ............2. The address and description of the location is ............ ............
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3. The owners are (names of individuals, partnership, membership corporation, or other type of corporation, religious order, etc.) ............ ............
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4. The proposed capacity of the psuchiatric service is ............5. The name, education and experience of the director of this service is ............ ............
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Applicant
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Title
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Date
N.Y. Comp. Codes R. & Regs. tit. 14, Appendices, app 2