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How to fill out the Dhs 35 online
Filling out the Dhs 35 form is a crucial step for outpatient mental health clinics seeking recertification in Wisconsin. This guide will provide you with a detailed, step-by-step approach to complete the form online accurately and efficiently.
Follow the steps to successfully complete the Dhs 35 form online.
- Press the ‘Get Form’ button to retrieve the Dhs 35 application form and open it in your preferred online editor.
- Fill in the name of the facility at the top of the form and provide the corresponding certification number. Ensure that you include the physical address, city, state, and zip code.
- Specify the accreditation information by selecting the applicable organization (JCAHO, COA, CARF, or others) and include the date of accreditation end.
- Next, enter the county and the date of the last accreditation visit. Provide the facility's telephone number, email address, and fax number.
- Complete the sections that pertain to the clinic administrator and the person completing the form, including their names, contact information, and their willingness to be included in the provider directory.
- Designate a facility contact person and provide their details as required. Ensure that their information is current and accurate.
- In the 'Agreement for electronic transmissions' section, indicate whether you agree to allow the Department to communicate via electronic methods for this application and all related documents.
- Complete the attestation section by signing and dating the application, affirming that all information provided is correct to the best of your knowledge.
- Review the instructions thoroughly and answer each question. Affirm 'Yes' or check 'No' based on whether your clinic meets the requirements, attaching any necessary additional documentation.
- Compile and attach any required documents, including additional narratives for all 'No' responses and branch office applications if applicable.
- Finally, save your changes, and choose to download, print, or share the completed form as needed before submission.
Complete your Dhs 35 application online today to ensure compliance and recertification for your outpatient mental health clinic.
To get a hold of the Department of Homeland Security, visit their official website to find relevant contact information for specific departments. You can also reach out via phone or through social media channels for inquiries. Engaging directly with DHS representatives can clarify concerns and questions you may have. If you require additional documentation when contacting DHS, UsLegalForms has resources available to help you prepare properly.
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