№ lp_2_3_18152
Official state regulatory application form requiring sworn statements, supporting documentation, and projected utilization data for approval of new medical technology equipment under Connecticut Certificate of Need statutes.
Jurisdiction: Connecticut
Legal Basis: Conn. Gen. Stat. §§19a-630, 19a-637, 19a-638, 19a-639, 19a-486
Document Type: Supplemental Certificate of Need Application Form
Subject: Acquisition of Equipment Utilizing New Technology
Applicant: Not specified
Project Title: Not specified
Affidavit Requirement: Signature of CEO or CFO and notarization required
Regulatory Authority: Connecticut General Statutes
Required Attachments: Vendor marketing materials or proposal; letters of support from medical practitioners; peer reviewed literature; Financial Worksheet data
Financial Reporting Component: Projected payer mix and discharge/visit volumes
Oversight and Accreditation: Governmental and professional approval/accreditation entities to be identified
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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