(a) Every notice of intent filed under 11.0220 shall be entitled “Notice of Intent for Health Facilities or Services Project” and shall contain at least the following information:

(1) Name and address of person or organization giving notice;

(2) Location and brief description of proposed project, including type of facility involved, any change in services contemplated, target population to be served;

(3) Amount, type, and sources of financing to be sought; and

(4) Best estimate of total capital expenditures necessary to complete the project.

(b) Also to be included with the notice of intent are any requests for agency ruling as to the necessity for an application for determination of need, requests for technical assistance in preparing application for determination of need, or request for preapplication conference.

(c) A notice of intent form shall be available from the agency upon request, but need not be used; provided, that the requirements of this section are met.

History: Rule 8-79, eff 16 Jul 79, Det. of Need Rules and Proc. § 11.2.