Application Forms & Publications

Nursing Home Administrator

Application Form

Address/Name Change/Duplicate License Request

Application Fillable Form

Nursing Home Administrator - Inactivation Application

Application Fillable Form

Nursing Home Administrator - Reactivation Application

Application Fillable Form

Abandoned Application Important Notice and FAQ's

Pursuant to §436B-9, Hawaii Revised Statutes, your application shall be considered abandoned and shall be destroyed if you fail to provide evidence of continued efforts to complete the licensing process for two consecutive years.