ORDER OF FEDERAL SERVICE ON SURVEILLANCE IN HEALTHCARE AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

of October 9, 2007 No. 3063-Pr/07

About approval of the document forms used by Roszdravnadzor when licensing medical activities

In pursuance of item 3 of the order of the Government of the Russian Federation of 11.04.2006 N208 "About Approval of the Document Form, Confirming License Availability" (The Russian Federation Code, 2006, N 16, the Art. 1746) and according to the order of the Government of the Russian Federation of 26.01.2006 N45 "About the Organization of Licensing of Separate Types of Activity" (The Russian Federation Code, 2006, N 6, the Art. 700), the Regulations on Federal Service on Surveillance in Healthcare and Social Development approved by the order of the Government of the Russian Federation of 30.06.2004 of N323 (The Russian Federation Code, 2004, N 28, the Art. 2900), the Regulations on licensing of medical activities approved by the order of the Government of the Russian Federation of 22.01.2007 of N30 (The Russian Federation Code, 2007, N 5, 656) I order to the Art.:

1. Approve the document forms used when licensing medical activities:

the statement for provision of the license for medical activities according to the appendix N1;

the statement for renewal of the document confirming availability of the license for medical activities according to the appendix N2;

the statement for provision of the duplicate/copy of the document confirming availability of the license for medical activities according to the appendix N3;

the notification on provision of the duplicate/copy of the document confirming availability of the license for medical activities according to the appendix N4;

the notification on provision of the license for medical activities according to the appendix N5;

the notification on renewal of the document confirming availability of the license for medical activities according to the appendix N6;

the notification on refusal in provision of the license for medical activities according to the appendix N7;

the notification on refusal in renewal of the document confirming availability of the license for medical activities according to the appendix N8;

the statement from the order of Roszdravnadzor according to the appendix N9;

the statement from the order of Roszdravnadzor according to the appendix N10.

2. To impose control over the implementation of this order on the deputy manager of Federal Service on Surveillance in Healthcare and Social Development I. F. Seryogina.

Appendix №1

to the order of Federal Service on Surveillance in Healthcare and Social Development of October 9, 2007 No. 3063-Pr/07

Statement for provision of the license for medical activities

 
      Регистрационный номер: ___________________________________
                            (заполняется лицензирующим органом)

                                         В ФЕДЕРАЛЬНУЮ СЛУЖБУ
                                         ПО НАДЗОРУ В СФЕРЕ
                                         ЗДРАВООХРАНЕНИЯ И СОЦИАЛЬНОГО
                                         РАЗВИТИЯ

                              Заявление
     (для юридического лица или индивидуального предпринимателя)

        О предоставлении лицензии на медицинскую деятельность

+--------------------------------------------------------------------+
/ 1.  /Организационно-правовая  форма   и/                           /
/     /полное  наименование  юридического/                           /
/     /лица;                             /                           /
/     /фамилия, имя  и  (в  случае, если /                           /
/     /имеется)     отчество,      данные/                           /
/     /документа,         удостоверяющего/                           /
/     /личность           индивидуального/                           /
/     /предпринимателя                   /                           /
/-----+----------------------------------+---------------------------/
/ 2.  /Сокращенное        наименование (в/                           /
/     /случае, если имеется)             /                           /
/-----+----------------------------------+---------------------------/
/ 3.  /Фирменное наименова�

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