Oregon Administrative Rules
Chapter 331 - OREGON HEALTH AUTHORITY, HEALTH LICENSING OFFICE
Division 10 - GENERAL ADMINISTRATION
Section 331-010-0040 - Notification Requirements

Universal Citation: OR Admin Rules 331-010-0040

Current through Register Vol. 63, No. 9, September 1, 2024

Authorization holders must notify the Office of information changes within 30 calendar days of the change. Notice must be submitted in writing, at the Office, by regular U.S. Postal Service, facsimile transmission, or electronic mail. Changes include:

(1) The authorization holder's first and last name. The change must be accompanied by:

(a) A government-issued marriage certificate or license (signed by a government official and including a filed date, stamp, seal or other notation showing that the document has been filed with a government agency);

(b) A certificate of registered domestic partnership issued by a city, county or state vital statistics agency;

(c) A U.S. city, county or state court-issued divorce decree, judgment of dissolution or annulment of marriage, or judgment of dissolution or annulment of domestic partnership;

(d) A government-issued death certificate of spouse, that includes a connection to your current full legal name (signed by a government official and including a stamp to show that the document has been filed);

(e) A U.S. city, county or state court-issued adoption decree;

(f) A U.S. city, county or state court-issued legal name change decree;

(g) A U.S. city, county or state court-issued custody decree or guardianship decree; or USCIS Certificate of Naturalization showing new name; and

(h) You must also provide one acceptable form of photographic identification in addition to the required legal name change documentation pursuant to OAR 331-030-0000(8) and (10).

(2) The authorization holder's residential or mailing address, telephone number including area code, employment status, or work location.

(3) A facility license holder's facility name or Assumed Business Name as filed with Secretary of State, Corporations Division, business telephone number, including area code, address changes resulting only from city or U.S. Postal Service action, mailing address; or closure or sale of business facility or practice.

(4) An independent contractor authorization holder's facility name, physical address, telephone number including area code, and license number; changing permanent work location or performing services at multiple licensed facilities on a permanent or temporary basis.

Statutory/Other Authority: ORS 676.565, ORS 676.615 & ORS 681.700-676.730

Statutes/Other Implemented: ORS 676.565, ORS 676.615 & ORS 681.700-676.730

Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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