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HME Forms and Applications


- If you are accredited by any of the accrediting organizations recognized by the Board, it is recommended that you apply for a certificate of registration. Please select the correct application.

The Board encourages HME candidates to complete a Facility Self Evaluation Form to determine if a license or certificate of registration is required to provide HME services. Ohio law regulates a select number of equipment services defined under ORC Section 4752.01 (B) and OAC rule 4761:1-3-02. If a facility does not provide one of the defined services, the facility may be excepted from the HME licensure requirements under ORC Chapter 4752. The Board encourages facilities to seek legal representation to review your qualifications for a license, certificate of registration or an exception to licensure requirements.

If you have any questions, please contact us at 614-644-4732.




77 S. High Street, 16th Floor • Columbus, Ohio 43215
Tel: (614) 752-9218 • Fax: (614) 728-8691