AGREEMENT BETWEEN SPONSORING ORGANIZATIONS AND UNAFFILIATED CENTERJuly 9th, 2013
FiledJuly 9th, 2013INSTRUCTIONS: An original and two copies of this Agreement must be completed and signed by the Facility’s Board Chairperson or Owner and returned to the Sponsoring Organization. An authorized representative of the Sponsoring Organization must sign all copies, keep one, send one back to the Facility’s Board Chairperson or Owner, and provide a copy to the Department of Health and Human Services (hereinafter referred to as the “State Agency”).