Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 5. Department of Health
Chapter 215. Rules and Regulations Governing Health Data Reporting
3/4/2024

FORMS (12VAC5-215).

Hospital Annual Historical Filing Form, 03-01, revised 4/30/96.

Ambulatory Surgical Hospital Annual Historical Filing Form, 03-02, revised 4/30/96.

Nursing Home Annual Historical Filing Form, 03-03, revised 4/30/96.

Income Statement Reconciliation Worksheet, 04-04, revised 4/30/96.

Psychiatric Hospital Annual Historical Filing Form, 03-05, revised 4/30/96.

Rehabilitation Hospital Annual Historical Filing Form, 03-06, revised 4/30/96.

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