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State of Connecticut Department of Social Services W-303 (Rev. 2/08) Client Supplement for Medical Information You asked for help from the Department of Social Services (DSS). You asked for this help.

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How to fill out the Dss Form W 303a online

Filling out the Dss Form W 303a is an essential step for individuals seeking assistance from the Department of Social Services due to health-related issues. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently online.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your personal details in Part A, including your name, DSS Client ID, address, social security number, date of birth, and contact information. Ensure you answer all questions regarding your living arrangements and health-related preferences.
  3. Move to Part B to provide detailed information about your health. List the doctors and clinics you visit, the health problems you are experiencing, and any medications you are currently taking.
  4. In Part C, describe your capabilities regarding daily activities. Be candid about your limitations and indicate if you require assistance with any tasks.
  5. Part D should capture your educational background and any special training you have undergone. Answer all questions regarding your past schooling and vocational experiences.
  6. Proceed to Part E where you will outline your work history, including job titles, types of businesses, and the duties you performed. Include information regarding how your health issues have impacted your work.
  7. After completing all sections, review your responses for accuracy and completeness. Once satisfied, you can save your changes, download, print, or share the completed form.

Complete and submit your Dss Form W 303a online to receive the support you need.

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Deidre Gifford as executive director of the Connecticut Office of Health Strategy (OHS) when he begins his second term in office early next year. Gifford is currently the commissioner of DSS and Barton Reeves is CEO of the Connecticut Paid Leave Authority.

**The Office of Child Support Services is open by appointment only, Monday – Friday, from 8 a.m. to 4 p.m. Office locations and contact information at .ct.gov/dss/childsupport/contact.

DSS is now available online (.connect.ct.gov), on the phone (1-855-6-CONNECT, or 1-855-626-6632), and in person at 12 offices (Field Offices).

Use the MyDSS mobile-friendly app: .ct.gov/mydss. Apply & renew services at .connect.ct.gov, plus get benefit status, notices, report changes, upload/send documents & more!

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