TX HHS Form 3216. Psychiatric Hospital License Application

The TX HHS Form 3216, Psychiatric Hospital License Application, is a crucial document for psychiatric hospitals in Texas seeking to obtain or renew their license. This form helps solve the problem of ensuring that psychiatric hospitals meet the necessary standards and requirements to provide quality care to patients. Typically, hospital administrators or owners fill out this form.

The form requires key information such as the hospital's name, mailing address, and contact details. It also asks for ownership information, including the legal name of the direct owner, their Social Security Number or Employer Identification Number (EIN), and type of ownership. Additionally, the form requests a copy of the IRS letter assigning the EIN, Certificate of Filing from the Office of the Secretary of State, and Organizational Chart showing Ownership Structure.

The TX HHS Form 3216 is used in situations where psychiatric hospitals are seeking to obtain or renew their license. Key points to note include:

• Required information includes hospital name, mailing address, contact details, ownership information, and supporting documents.
• The form is typically filled out by hospital administrators or owners.
• The form helps ensure that psychiatric hospitals meet necessary standards and requirements to provide quality care to patients.