Get 0938 0734 Form

Filling out the 0938 0734 Form requires careful attention to detail to ensure that all necessary information is accurately provided. This guide offers clear, step-by-step instructions to assist you through the online form filling process.

Follow the steps to successfully complete the 0938 0734 Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online document editor.
2. In the first section, specify whether this is an addendum to a previously approved Data Use Agreement (DUA). If so, insert the CMS assigned DUA number.
3. List the individual(s) who may have access to the CMS data for Title II ADA/Olmstead activities by providing their name and title in the specified fields.
4. Describe the task or role of each individual in the project clearly.
5. Enter the name of the company or organization of each individual in the designated area.
6. Fill out the street address, city, state, office telephone (including area code), e-mail address (if applicable), and ZIP code for each individual.
7. Each individual must provide their signature and date in the respective fields.
8. If applicable, the signature of the CMS representative and the CMS project officer should also be included.
9. Review the completed form for accuracy and completeness to ensure all required fields are filled out.
10. Once satisfied, save changes, download, print, or share the completed form as needed.

Begin the process by completing the 0938 0734 Form online today.