Get I-97 06.pdf - Dss Cahwnet

This guide provides clear and supportive instructions for completing the I-97 06.pdf - Dss Cahwnet form online. By following these steps, you will ensure that you properly fill out the form to meet the necessary requirements.

Follow the steps to complete the I-97 06.pdf - Dss Cahwnet form online.

1. Press the ‘Get Form’ button to access the form and open it in your chosen online editor.
2. Enter the name of the IHSS recipient in the designated field.
3. Provide the recipient’s telephone number for contact purposes.
4. Fill in the address of the IHSS recipient, indicating where care will primarily be provided.
5. Input the name of the primary contact responsible for coordinating the 24-hour-a-day coverage plan.
6. Enter the primary contact’s telephone number.
7. Describe the relationship between the primary contact and the recipient (e.g., family member, friend, care provider).
8. List the names of care providers responsible for the recipient’s 24-hour-a-day care and include their contact numbers.
9. If additional care providers are needed, attach a separate sheet with their names and contact information.
10. Explain the implementation of the coverage plan in the designated area, detailing the schedule or arrangement for care.
11. The primary contact responsible should sign and date the form after discussing the plan with the IHSS social worker.
12. Finally, the IHSS social worker will sign the form and provide their contact number. Ensure that a copy of the completed form is provided to the primary contact and retained in the County case file.

Complete your documents online to ensure a smooth process.