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Get Il478 0063 Form

Gov/ltc/ The revised Form HFS 1156 may be downloaded at www. hfs. illinois. gov/medicalforms/ If you have any questions contact the Bureau of Long Term Care at 217-782-0545. Rod R. Blagojevich Governor Barry S. Maram Director 201 South Grand Avenue East Springfield Illinois 62763-0002 Telephone 217 782-1200 TTY 800 526-5812 INFORMATIONAL NOTICE DATE June 21 2007 TO Intermediate Care Facilities for the Developmentally Disabled ICF/DD RE Revised Fo.

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