609 form 2026

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4.9 out of 5

506 votes

The document is a form from the California Department of Public Health designed to request specific types of beds and services for health facilities. It outlines the information required for both new and existing facilities, including details on existing and requested beds, as well as existing and requested services. The form must accompany an application for changes in facility capacity or type.

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Click ‘Get Form’ to open the 609 form in the editor.
Begin by entering the name of your facility, type, and address in the designated fields. Ensure all information is accurate for processing.
In the 'Existing Beds' and 'Requested Beds' sections, input the number of beds for each category as applicable. This includes various types such as Acute Respiratory and Intensive Care.
Next, check off any existing services your facility provides in the 'Existing Services' section. Be sure to include special permit services if applicable.
Finally, complete the 'Requested Services' section by marking any additional services you wish to request. Specify any other services not listed.

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Versions	Form popularity	Fillable & printable
2008	4.9 Satisfied (506 Votes)

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