Get Hud Medical Expense Verification Form

Completing the Hud Medical Expense Verification Form is an essential step in verifying medical expenses for housing assistance. This guide will help you navigate each section of the form to ensure accuracy and completeness.

Follow the steps to accurately fill out the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editing interface.
2. Begin by entering your personal information in the designated fields. Include the recipient's name, address, and other identifying details at the top of the form.
3. Fill in the RE (regarding) section with the unit number and Social Security Number (SSN) related to the household member applying for assistance.
4. In the household member release section, indicate whether the household member wishes to release information. If yes, sign and date it in the provided spaces.
5. Complete the medical expense details by specifying the requested dates, including the total number of visits in the last twelve months and the anticipated visits for the next twelve months.
6. Fill in the total out-of-pocket expenses paid in the last twelve months and anticipated for the next twelve months in the respective fields.
7. Provide the account balance the client is responsible for and answer the question regarding regular monthly payments, specifying the amount if applicable.
8. Include any additional comments that you believe may be relevant to the expense verification.
9. Finish the form by certifying that the information provided is true and correct. Sign and print your name along with your title, telephone number, and date.
10. Once all fields are filled, review the form for accuracy, then you can save, download, print, or share the completed form as needed.

Start your online submission by completing the Hud Medical Expense Verification Form today.