Get Form 1579 Referral For Relocation Services

Filling out the Form 1579 Referral for Relocation Services is an important step in facilitating the relocation process for applicants. This guide is designed to help users navigate the form online with clarity and ease.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering the applicant's name in the designated field at the top of the form.
3. Provide the applicant's area code and telephone number for contact purposes.
4. Fill in the nursing facility’s name where the applicant is currently residing.
5. Complete the facility address section with accurate location details.
6. If applicable, enter the name of the responsible party for the applicant.
7. Input the area code and telephone number of the responsible party.
8. Document the date and time when the nursing facility was contacted.
9. Provide the facility’s area code and telephone number for further reference.
10. If there is a guardian involved, specify their type (e.g., legal guardian).
11. Select the appropriate relocation contractor type, such as 'Financial Only' or 'Medical Only', and include the contractor's area code and telephone number.
12. List the contractor's address clearly.
13. State the relocation needs by indicating if the applicant has a community residence or requires assistance finding housing.
14. Answer the questions regarding participation in the Money Follows the Person Demonstration and whether Transition Assistance Services are needed.
15. Provide the name of the selected Transition Assistance Services provider if available.
16. Mention if the applicant has previously utilized Transition Assistance Services.
17. Indicate any family or informal supports involved in the relocation process by providing their names, phone numbers, and relationships.
18. Add any other relevant information or specific relocation needs in the provided section.
19. Include the mailing address and contact details of the DADS case manager, MCO service coordinator, or SPSU coordinator.
20. Finally, enter the date of referral before concluding the form.
21. Once all sections are completed, save your changes, and choose to download, print, or share the form as necessary.

Start completing your Form 1579 Referral for Relocation Services online today.