Welcome to the State of California 

Home Medical Device Retailer (HMDR) License Applications

This page links to the current application forms for both the firm license application needed by each individual facility location where home medical devices (prescription Rx devices and non prescription devices) will be sold, leased or rented when ordered by a physcian or other prescriber.  The application for the HMDR exemptee is also linked here for firms who wish to sell prescription Rx devices such as respiratory equipment, medical oxygen and other equipment identified as dangerous or legend devices under California law.  Please see the FAQ page for further details or contact the license desk directly as noted on the application form.  These forms may be filled out online using the Adobe reader but must be printed out,  signed and returned to the license desk to complete the license application process.

 

  • HMDR California Facility License Application (PDF) Document will open in new window.
  • HMDR Out of State Facility License Application (PDF) Document will open in new window.
  • HMDR Exemptee Application (PDF) Document will open in new window.
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    Last modified on: 1/2/2013 11:43 AM