Applications and Forms

• BHA License Application (PDF)
• Deeming Application (PDF)
• Mobile/Fixed-Site Medication Unit Notification (PDF)
• Hospital BHA Additional Site Form (PDF)
• BHA Closure Form (PDF)
• Disclosure Statement (PDF) 

See the Tribal Attestation webpage.

• BHA License Application (PDF)
• Community Relations Plan (PDF)
• Mobile/Fixed-Site Medication Unit Notification (PDF)

• All BHA applications for initial licensure and certification or adding certifications and services must include the submission of policies and procedures for review and approval. An agency's policies and procedures must address the requirements in chapter 246-341 WAC, and describe how the WAC requirements are implemented at your agency.
• WAC 246-341 Policy and Procedure Review Tool (PDF) – this tool is designed as a guide for developing policies and procedures.