TX HHS Form 3216. Psychiatric Hospital License Application

The TX HHS Form 3216, Psychiatric Hospital License Application, is a crucial document used to apply for a psychiatric hospital license in Texas. This form helps solve the problem of obtaining the necessary permit to operate a psychiatric hospital, ensuring compliance with state regulations.

This application requires key information about the hospital, including its name, mailing address, and contact details. The form also gathers data on ownership, including the legal name of the direct owner, their employer identification number (EIN), and type of ownership. Additionally, applicants must provide a projected date for when the hospital will open, as well as architectural project numbers if applicable.

The TX HHS Form 3216 is typically used by psychiatric hospitals seeking to obtain or renew a license in Texas. The form's instructions highlight important sections, such as Section 1: Hospital Information and Section 2: Ownership Information, which must be completed accurately and thoroughly. Applicants should note that certain documentation, including IRS letters and organizational charts, may be required to support their application.