gold_ball.gif (1008 bytes) Hospice Services Home Page
gold_ball.gif (1008 bytes) Applications
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gold_ball.gif (1008 bytes) Duplicate License
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gold_ball.gif (1008 bytes) Initial License
gold_ball.gif (1008 bytes) Labels and Listings
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Hospice Services
Duplicate License

The form may be completed on-line, however, it cannot be submitted via e-mail due to the fact that all applications and forms require original signatures. If you complete the form on-line, you must print the form and mail it to the address below.

A duplicate or reissued license is available for a fee of $10.00. PDF File Duplicate/Reissue Form

DHHS, Division of Public Health
Office of Outpatient and In-Home Care Services
PO Box 94986
Lincoln, NE 68509

 

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