1. (1) Any person who wishes to propose that the State Health Planning and Development Agency adopt, amend, or repeal any rule shall submit said proposal in the following form:

   1. (a) Petition for Adoption of Rule

      1. 1. Petitioner

         1. (i) Name
         2. (ii) Address
         3. (iii) Phone

      2. 2. Character of Change

         1. (i) ( ) adopt the following rule.
         2. (ii) ( ) amend Rule __________ as follows.
         3. (iii) ( ) repeal Rule __________ in total.

         I propose that the State Health Planning and Development Agency

      3. 3. Text of Proposed Rule

         If you checked box "i" above, type the rule you propose. If you checked "ii" above, type the currently effective rule, adding any proposed language. Proposed new language should be underlined and proposed deletions should be marked through. If you checked box "iii" above, skip this and go to part 4.

      4. 4. Purpose of Change

         Briefly describe what the effect of this change will be, and why you believe the change should be made.

      5. 5. Signature

         1. (i) _____________________________                                   Date
         2. (ii) ______________________________                              Petitioner

Statutory Authority: Code of Ala. 1975,