hrla: ICF Application Package
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Intermediate Care Facilities For Mentally Retarded Persons
Application Package
 
The applications package for Intermediate Care Facilities for Mentally Retarded Persons must include all documents listed in the chart below. The Intermediate Care Facilities staff reviews each application package and determines an applicant's eligibility for a license. Please follow the instructions for the Printable Forms and include all forms in the application package in hard copy format.
 
Printable Forms: Print the form, fill it out, sign it, and include it with the application package. Specific instructions are provided within each form below.
 
 
Application Information Documents
Application Instructions*
 Regulations