Get Ocal-1049, Afc Group Application Packet - State Of Michigan - Mich

Filling out the OCAL-1049, AFC Group Application Packet is an important step in initiating the process for adult foster care licensing in Michigan. This guide provides clear, step-by-step instructions to assist users with completing the form accurately and efficiently.

Follow the steps to successfully complete the application packet.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred browser.
2. In the 'Applicant/Licensee Information' section, carefully fill in the facility or home name, license number, and complete address including street number, city, state, and zip code.
3. Identify the licensing consultant by entering their name, address, and phone number accurately beneath the previous information.
4. Specify the license application type, indicating whether it is for adult foster care, child foster care, or child care, and fill in the capacity section as required.
5. Proceed to the 'Patient Information' section, entering the patient's full name, date of birth, address, social security number, and phone number.
6. In the 'Release of Information' section, the patient must authorize the release of their medical information by signing and dating the form, and providing their physician’s name.
7. The 'Medical Information' section is to be completed by the physician. They should check if the patient has been tested for tuberculosis, providing the test type and results as necessary.
8. The physician must describe the patient’s physical and mental condition, indicating any conditions that could affect their ability to work with children or dependent adults, using the comments section for additional details.
9. If needed, indicate whether the physician would like to be contacted by the licensing consultant regarding their recommendations.
10. Finalize the form by having the licensed physician or their designee sign and date the form, and provide their address information.
11. Review the completed form for accuracy. Save any changes you have made. If necessary, download, print, or share the form for further processing.

Complete the OCAL-1049 form online today to ensure a smooth application process.