The legal representative of the establishment, institute or school submits the application for approval of the Director to the Chairman of the Regional Council, with a copy to the Director General of the Regional Health Agency.
If the President of the Regional Council remains silent for more than two months from receipt of the complete application for approval, this will be deemed to constitute approval.
Approval may be withdrawn after formal notice and by reasoned decision if the conditions set out in article R. 4383-4 are no longer met.