Get Form 02cb005e. Service Team Release Of Information

Filling out the Form 02CB005E is a crucial step in managing your service provider changes effectively. This guide will assist you in completing the form with clarity and precision, ensuring your information is accurately captured and submitted online.

Follow the steps to fill out the Form 02CB005E online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor. This allows you to start the process of filling out the necessary information.
2. Begin with the member's last name, first name, and middle initial. Enter these details exactly as they appear in official documents.
3. Fill in the member's street address, city, county, state, and zip code. Ensure that the address is complete and accurate to avoid any delays.
4. In the 'Member choice and consent' section, ensure to initial next to the services you have been informed about and select your new case management and home care providers.
5. Authorize the Oklahoma Department of Human Services to share your assessment information with the new providers by reading and signing the authorization statement. Make sure to understand the implications of this consent.
6. Sign the form as the member or legal agent. If signing with a mark, ensure that two witnesses sign the document as well.
7. Have the required signatures from witnesses where applicable and note the date of each signature.
8. Conclude by reviewing the entire form for completeness and accuracy before saving changes, downloading, printing, or sharing the completed form.

Complete your documents online and ensure prompt processing of your service changes.