Comprehensive Medical Tenant Alteration Request & Approval System

1. Requestor & Tenant Identification

Please provide complete legal and operational information for the tenant entity requesting alterations. All fields marked mandatory must be completed for processing.

 

Entity Name (as on lease)

Doing Business As (DBA) Name

Authorized Representative Full Name

Representative Title

Email Address

Direct Phone Number

Facility Type Classification (select all that apply)

 

OUTPATIENT SURGERY CENTER: You must complete Section 9 (Outpatient Surgery Specific Requirements) and provide ASC compliance documentation.

 

CLINICAL LABORATORY: You must complete Section 8 (Laboratory Specific Requirements) and provide biosafety and chemical safety documentation.

 

PATHOLOGY LABORATORY: You must complete Section 8 (Laboratory Specific Requirements) with emphasis on hazardous biological material handling.

 

COMBINED FACILITY: You must complete ALL relevant specialty sections (8, 9) that apply to your combined operations.

2. Premises & Lease Details

Building Name

Suite/Unit Number

Floor Number

Total Leased Square Footage (sq ft)

Current Lease Start Date

Current Lease End Date

Current Use of Space

Proposed Use After Alterations

3. Project Overview & Timeline

Project Title

Detailed Project Description

Primary Reason for Alteration

Requested Construction Start Date

Requested Construction Completion Date

Total Estimated Construction Duration (days)

Proposed Construction Schedule (select all applicable windows)

 

Will weekend work require HVAC system operation beyond normal building hours?

 

Will night work require continuous security escort?

4. Architectural & Structural Alterations

Will the project involve adding or removing non-load-bearing partitions?

 

Describe partition modifications including materials, fire-rating requirements, and locations

Will the project modify any load-bearing walls or structural elements?

 

Provide detailed structural engineer assessment and proposed modifications

Will ceiling height or configuration be altered?

 

Describe ceiling modifications including impact on fire sprinkler heads, lighting, and HVAC diffusers

Will flooring materials be changed?

 

New flooring type

Will doors, frames, or hardware be modified?

 

Specify door ratings, hardware types (panic, closers, locks), and accessibility compliance

Will accessibility features (ramps, handrails, clearances) be added or modified?

 

Has a universal design/accessibility consultant reviewed the plans?

5. Mechanical, Electrical & Plumbing Systems

Will HVAC systems be modified, upgraded, or rebalanced?

 

Describe HVAC changes including air changes per hour, filtration upgrades (HEPA?), pressure relationships, and temperature/humidity control

Will the electrical service or distribution be upgraded?

 

Electrical Load Additions

Equipment Name

Voltage

Amperage

Quantity

Total Watts

A
B
C
D
E
1
MRI Scanner
480
100
1
48000
2
Surgical Light
120
5
3
1800
3
 
 
 
 
0
4
 
 
 
 
0
5
 
 
 
 
0
6
 
 
 
 
0
7
 
 
 
 
0
8
 
 
 
 
0
9
 
 
 
 
0
10
 
 
 
 
0

Will plumbing systems or fixtures be added/relocated?

 

Describe plumbing changes including domestic water, sanitary waste, acid waste, or specialty systems

Will fire suppression (sprinkler) or fire alarm systems be modified?

 

Detail fire system modifications including sprinkler head additions, relocations, alarm device changes, and fire marshal approvals

6. Medical Gas Systems & Critical Life Safety

Will medical gas piping or outlets be installed, modified, or removed?

 

Select all medical gas systems involved

Will the project require installation of medical gas alarm panels or zone valves?

 

Number of new zone valve boxes

Has a certified medical gas installer been engaged?

 

Installer company name and certification number

Will verification, testing, and certification be completed per applicable standards?

Will emergency power (UPS/generator) systems be added or modified?

 

Describe emergency power loads, transfer switches, and connectivity to building system

7. Infection Control Risk Assessment (ICRA) & Patient Safety

Healthcare construction requires strict infection control. ICRA Type definitions: Type I (low risk, non-patient areas), Type II (medium risk, patient areas, no construction dust), Type III (high risk, active patient care, dust containment required), Type IV (highest risk, critical care, negative pressure required), Type V (pathology labs, biosafety).

 

ICRA Construction Type Classification

Will the construction area require negative pressure isolation?

 

Required negative pressure differential (inches of water column)

Will patient care operations continue during construction?

 

Describe patient safety plan including temporary barriers, alternate egress routes, noise mitigation, and communication protocols

Will sterile processing, pharmacy clean rooms, or isolation rooms be impacted?

 

Detail protective measures and temporary relocation plans

Has an ICRA permit been completed with the facility's infection prevention department?

 

Upload signed ICRA permit and risk mitigation plan

Choose a file or drop it here
 

Risk Assessment Matrix - Rate the potential impact on the following areas

Minimal

Low

Moderate

High

Critical

Airborne infection risk

Water supply contamination

Noise disruption to patient care

Emergency access obstruction

Vibration affecting sensitive equipment

8. Laboratory Specific Requirements

Does this project involve a clinical or pathology laboratory?

 

Biosafety Level (BSL)

 

BSL-3 and BSL-4 requirements: You must provide detailed containment protocols, HEPA filtration specifications, and independent exhaust systems.

 

Will fume hoods or biological safety cabinets (BSC) be installed or relocated?

 

Fume Hood/BSC Schedule

Equipment Type

Make/Model

Face Velocity (fpm)

Connected to Building Exhaust?

Requires Dedicated Exhaust Fan?

A
B
C
D
E
1
 
 
 
 
 
 
 
2
 
 
 
 
 
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Will hazardous chemicals be stored or used in quantities exceeding standard allowances?

 

List chemical categories, volumes, storage cabinet types, and spill containment measures

Will laboratory waste systems (acid waste, biological waste) be installed?

 

Describe waste neutralization, disinfection, and disposal systems

9. Outpatient Surgery Center Specific Requirements

Does this project involve an outpatient surgery or procedure center?

 

Number of new or modified operating/procedure rooms

Will operating rooms be classified per surgical invasiveness standards?

 

OR Classification

Will anesthesia gas scavenging systems be installed?

 

Number of WAGD (Waste Anesthetic Gas Disposal) outlets

Will pre-operative and post-anesthesia recovery (PACU) areas be created or modified?

 

Number of recovery bays

Will sterile processing and instrument decontamination areas be included?

 

Will these areas meet sterile processing department (SPD) workflow standards (dirty to clean to sterile)?

Will there be dedicated emergency power for life-sustaining equipment in surgery areas?

 

List equipment on emergency power and required uptime (e.g., 2-hour, 24-hour, 72-hour)

10. Contractor, Safety & Compliance Documentation

General Contractor Company Name

Primary Contractor License Number

Contractor Safety Officer Contact

Has the contractor completed healthcare facility ICRA training?

 

Upload ICRA training certificates for all on-site personnel

Choose a file or drop it here
 

Will the contractor provide current certificates of insurance (COI) with adequate coverage?

 

List coverage types and limits (General Liability, Workers Comp, Professional Liability)

Has a comprehensive safety plan been developed?

 

Upload safety plan including fall protection, electrical lockout, and hazardous materials handling

Choose a file or drop it here
 

Will hot work (welding, cutting) be performed?

 

Has a hot work permit process been established with building management?

11. Impact Assessment & Logistics

Will the project require planned utility shutdowns (power, water, HVAC)?

 

Utility Shutdown Schedule

Utility Type

Shutdown Start

Date & Time

Shutdown End

Date & Time

Affected Areas

Patient Care Impact?

A
B
C
D
E
1
 
 
 
 
 
2
 
 
 
 
 
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Will construction generate noise or vibration affecting adjacent tenants or patient areas?

 

Describe mitigation measures: sound barriers, vibration isolation, work scheduling

Will there be any temporary occupancy or egress path changes?

 

Upload temporary life safety plan showing alternate egress routes

Choose a file or drop it here
 

Will hazardous materials (asbestos, lead, silica) be disturbed?

 

Describe abatement procedures and licensed remediation contractor details

Has a communication plan been developed for notifying patients and staff?

 

Describe notification methods and timeline

12. Documentation & Technical Submissions

Upload architectural demolition and construction drawings (PDF format)

Choose a file or drop it here
 

Upload MEP (Mechanical, Electrical, Plumbing) engineered drawings

Choose a file or drop it here
 

Upload reflected ceiling plan showing all MEP overlays

Choose a file or drop it here
 

Will new medical equipment be installed?

 

Medical Equipment Schedule

Equipment Name

Manufacturer

Weight (lbs)

Power Requirements

Vibration Sensitive?

A
B
C
D
E
1
 
 
 
 
 
2
 
 
 
 
 
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Are product specifications and material safety data sheets available?

 

Upload specifications binder

Choose a file or drop it here
 

Have local building authority permits been applied for?

 

Permit application number

13. Financial & Fee Responsibility

Total Estimated Construction Cost

Architectural & Engineering Fees

Permit & Inspection Fees

Building Management Review Fee (if applicable)

Financial Responsibility per Lease

Has a security deposit or letter of credit been provided for potential building damage?

Will the alteration increase the leasable value and affect future rent?

 

Describe lease amendment process

14. Certifications, Approvals & Signatures

I certify that all information provided is accurate and complete to the best of my knowledge

I acknowledge that construction cannot commence until written approval is granted by building management and all required permits are obtained

I confirm that all contractors will comply with building rules, infection control protocols, and safety requirements

Authorized Tenant Representative Signature

Signature Date & Time

 

FOR BUILDING MANAGEMENT USE ONLY: Review and approval of this request does not constitute waiver of lease provisions or approval of regulatory compliance. Separate permits and inspections are required.

 

Building Management Reviewer Name

Review Decision

Management Comments & Conditions

Building Management Authorized Signature

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