COVID-19 INFORMATION

Application and Filing Fee Submission Process due to the pandemic

HSDA Rulemaking (Updated)

Forms

If requesting a Word version of the following files, please email your request to hsda.staff@tn.gov .

Versions of the following forms dated prior to September 1, 2021 will not be accepted.

CON Applicant Self Check List (Optional)

Instructions for Completing Certificate of Need Application

Letter of Intent/Publication of Intent

Certificate of Need Application

Attachment-Bed Count

Attachment-Licensed County

Attachment-Medical Equipment

Attachment-Tennessee County Map

Letter of Intent/Publication of Intent-Relocation Exemption

Relocation Exemption Request

Affadavit for CON Application

Affadavit for Supplemental Responses

Affadavit for Lost Certificate of Need Certificate

Annual Progress Report

Final Project Report

Link to Medical Equipment Forms

Change of Ownership Form

Intent to Alter Existing Bed Capacity

Copy Request Form

Public Records Request Form