Follow the steps to fill out the Cd 9600 Form correctly.

1. Press the ‘Get Form’ button to acquire the form and open it in the editor.
2. Complete Part I of the form. This section requires input from both the authorized agency representative and the incapacitated parent. Provide your name, signature, and the date, along with the names and ages of your children for whom financial assistance is being requested.
3. Fill in the details for the authorized agency. This includes the name of the agency, the representative's name, and their contact telephone number.
4. In Part II, the licensed health professional must verify the parental incapacity. They will need to indicate whether the incapacity is due to a physical or mental health condition and the specific times and days when care or supervision cannot be provided.
5. Specify the days of the week when the parent is unable to provide care and outline the time ranges, ensuring not to exceed 50 hours per week.
6. If the exact times are uncertain, the health professional may indicate the total number of hours required for care and which days assistance is needed.
7. The health professional must sign and submit the form to the agency listed in Part I within 15 days of receipt.
8. Once completed, you can save your changes, download a copy of the form, print it, or share it as necessary.

Complete your Cd 9600 Form online today to ensure you receive the support you need.