Approved CEU Courses
Arizona Department of Health Services (DHS) - Article 8
Arizona Department of Health Services (DHS) statutes
CEU extension request form
CEU extension request form can be used between April 30th and July 31st to request an extension of time to complete the CEU requirement for license or certificate renewal. The form must be filled out and uploaded with all required attachments as a service request in the elicense portal.
Change of Address
To change your mailing address fill out the attached form and follow the instructions to submit the form.
Continuing Education
Directory of Managers
Duplicate Administrator License request form
Duplicate Administrator License request form must be filled out and uploaded with the service request in the elicense portal. Mail or fax forms will not be accepted.
Duplicate Manager Certificate request form
Duplicate Manager Certificate request form must be filled out and uploaded with the service request in the elicense portal. Mail or fax forms will not be accepted.
Exam Schedule - Board's statutes
Exam Schedule - rules
Initial Manager Training Program
Letter of Intent to Appoint a Temporary Administrator
Letter of Intent to Appoint a Temporary Administrator. This form should be submitted with an initial application for temporary licesne or uploaded with the service request in the elicense portal. Mail or fax forms will not be accepted.
Letter of Intent to Appoint a Temporary Manager
Letter of Intent to Appoint a Temporary Manager. This form should be submitted with an initial application for a manager certificate or uploaded with the service request in the e-licensing portal. Mail or fax forms will not be accepted.