Get Dshs 13 727

The DSHS 13 727 form is essential for individuals seeking medical necessity approval for wheelchair purchases. This guide offers a step-by-step approach to filling out the form online, ensuring clarity and efficiency for both vendors and healthcare professionals.

Follow the steps to complete the Dshs 13 727 form accurately.

1. Click 'Get Form' button to obtain the DSHS 13 727 form and open it in your preferred online editor.
2. In Section 1, begin by entering the client’s name and client ID. If applicable, include the nursing facility information and the fax number.
3. Proceed by filling in the measurements for lower leg length, upper leg length, and hip measurements in inches, as specified.
4. Sign and date Section 1, ensuring all fields are completed as failure to do so may delay processing.
5. In Section 2, provide details about the client’s diagnosis, height, weight, and assessments related to the wheelchair's necessity.
6. Complete additional assessments regarding the accessibility of the client’s home for the requested wheelchair.
7. Review the completed form for any omissions. Ensure both the physician or therapist's signature is included with the respective dates.

Complete your DSHS 13 727 form online to ensure a timely review of your wheelchair purchase request.