About various application procedures for independence support medical institutions (rehabilitation medical care / nurturing medical care)

Please fill out the application form below and submit it to the Shizuoka City Community Rehabilitation Promotion Center for various applications for designated medical institutions for supporting independence (rehabilitation medical care and medical care for fostering).

《Application for new designation》
Designated Medical Institution for Supporting and Supporting Independence (Rehabilitation Medical Care/Nurture Medical Care) Designation Application Form (Hospital or Clinic) Application Form ・ Entry Example
Designated Medical Institution for Supporting and Supporting Self-Reliance (Rehabilitation Medicine/Nursing Medicine) Designation Application Form (Pharmacy) Application Form / Entry Example
Designated Medical Institution for Supporting and Supporting Self-Reliance (Rehabilitation Medical Care/Nursing Medical Care) Designation Application Form (Home-Visit Nursing Service Provider, etc.) Application Documents / Entry Example

《Designated Renewal Application》
Designated Medical Institution for Supporting and Supporting Self-Reliance (Rehabilitation Medical Care/Nurture Medical Care) Designation Renewal Application Form (Hospital or Clinic) Application Form ・ Entry Example
Designated Independence Support Medical Institution (Rehabilitation Medicine/Nurture Medicine) Designation Renewal Application Form (Pharmacy) Application Documents / Entry Example
Designated Independence Support Medical Institution (Rehabilitation Medical Care/Nurture Medical Care) Designation Renewal Application Form (Home-visit Nursing Service Provider, etc.) Application Documents / Entry Example

《Change application》
Designated Medical Institution for Supporting and Supporting Persons with Disabilities (Rehabilitation Medical Care/Nursing Medical Care) Notification of Changes (Hospital or Clinic) Application Documents / Entry Example
Designated Medical Institution for Supporting and Supporting Persons with Independence (Rehabilitation Medicine/Nursing Medicine) Notification of Changes (Pharmacy) Application Form / Entry Example
Designated Medical Institution for Supporting and Supporting Independence (Rehabilitation Medical Care/Nursing Medical Care) Notification of Changes (Home-visit Nursing Providers, etc.) Application Form / Entry Example

《Application for designated suspension, resumption, abolition, etc.》
Designated Independence Support Medical Institution (Rehabilitation Medical Care/Nurture Medical Care) Designated Suspension, Resumption, Abolition Notification Form (All Common) Application Documents/Entry Example

《Application for withdrawal from designation》
Designated Independence Support Medical Institution (Rehabilitation Medical Care/Nurture Medical Care) Designation Refusal Notification (Common to All) Application Documents / Entry Example

《Self-check list》
Designated Medical Institution for Supporting and Supporting Independence (Rehabilitation Medicine/Nurture Medical Care) Self-Check Sheet (Hospital or Clinic) Self-Check Sheet ・Entry example
Designated Medical Institution for Supporting and Supporting Independence (Rehabilitation Medicine/Nurture Medicine) Self-Check Sheet (Pharmacy) Self-Check Sheet ・Entry example
Designated Medical Institution for Supporting and Supporting Independence (Rehabilitation Medical Care/Nursing Medical Care) Self-Check Sheet (Home-Visit Nursing Service Providers, etc.) Self-Check Sheet ・Entry example

《Examination Criteria》
Examination criteria for designated medical institutions for supporting independence (rehabilitation medicine/nurturing medicine) Examination criteria

<Submit to>
Shizuoka City Regional Rehabilitation Promotion Center
〒420-0846
Telephone 054-249-3182
Fax: 054-209-0103
mail chiikirehabili@city.shizuoka.lg.jp