CON Applications and Forms
IMPORTANT NOTICE REGARDING ELECTRONIC FILING
Effective immediately (March 31, 2022), pursuant to Ga. Comp. R. & Regs. r. 111-2-2-.06(6), all Office of Health Planning applications and requests must be submitted electronically through our website. We are no longer accepting in-person filings.
In the event the Office of Health Planning’s web portal is not available, filers should send their timely submissions along with a screenshot showing the unavailability of the web portal to [email protected] for handling. The date and time stamp of such email will serve as the receipt date and time.
The following links provide access to forms that can be downloaded and completed using Microsoft Word or Adobe Acrobat Reader. To save a form to your computer, right-click the form link (Control-click on Macintosh) and choose "Save Target As..." and save to your computer. (The specific command may differ based on your browser and operating system). You can then open the saved form, fill-in the requested information, and submit the form. Specific requirements regarding submitting the forms can be found on each form. These requirements must be followed exactly. Forms should be uploaded in PDF format at the original print resolution (300 DPI) and must not be altered or edited beyond entering the required information. Adhering to the above instructions is crucial for a proper submission.
Office of Health Planning Form Submission Portal
Certificate of Need Project Forms
- Georgia CON Batching Application Letter of Intent Form - Updated 5/7/2020
- Georgia CON Application Form - Updated 11/15/2022
- Additional Information Form - Updated 05/7/2020
- Amendment Request Form - Updated 05/17/2022
- Notice of Opposition Form - Updated 05/07/2020 (Applies to post July 1, 2008 CON Applications)
- CON Performance Extension Request - Updated 07/02/2020
- CON Project Progress Report Forms
- General Cancer Hospital CON Application Form - 07/30/2019
Letter of Determination Request Forms
Request for Determination Form
- Updated 8/9/2021
- (Now includes Exhibit 5 for Therapeutic Cardiac Catheterization Exemption Requests)
- Equipment Determination Form (formerly, Equipment Letter of Non-Reviewability) – Updated 10/07/2021
- Ambulatory Surgical Center Determination Form - Updated 11/15/2022