Skip Navigation LinksGACH-APH-CHGB-Provider-Checklist

Top Menu
Left Menu

HEALTH CARE FACILITY LICENSING AND CERTIFICATION​​​

​​​​General Acute Care Hospitals and Acute Psychiatric Hospitals

Change of Governing Board

Required Documents

Online Application PDF Form

  • Embedded and generated by online system

Appointment To the Board Information Organization

  • ​Documents which show appointment to the board

    • ​Corporation – Submit meeting minutes, Articles of Incorporation and By-Laws

    • LLC – Submit meeting minutes, Articles of Organization and Operating Agreement

Licensee/Business Entity Information

  • ​​Organizational chart displaying the following information: applicant’s owners, directors, board members, corporate officers, LLC members/managers, and partners

    • ​​​​​​​The organizational chart prior to the change

    • The organizational chart after the change

Helpful Tip

  • If licensee/entity includes multiple facilities, then only one Change of Governing Board (CHGB) application is required from one facility.

Page Last Updated :