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                Get Form 470 3767
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How to fill out the Form 470 3767 online
Filling out the Form 470 3767 is a crucial step for agencies accessing confidential child and dependent adult abuse information. This guide provides a user-friendly, step-by-step approach to completing the form online, ensuring that users can navigate the process with ease.
Follow the steps to complete the Form 470 3767 online effectively.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the name of your facility or agency in the designated field. Ensure that the name is correct, as this identifies your organization for access purposes.
- Provide the billing account number in the relevant section. This number is essential for tracking your agency's access and is provided upon approval of your SING account.
- Type or print the name of the administrator responsible for signing the agreement. This individual must be authorized to commit the agency to comply with the terms outlined in the form.
- Obtain the signature of the administrator in the indicated space. This signature signifies your agency’s agreement to adhere to the legal provisions regarding access to confidential abuse information.
- Review all sections of the form to ensure accuracy and completeness before submitting. Accurate information is crucial for the processing and approval of your form.
- Once completed, save changes to the form. You can also download a copy for your records, print the form, or share it with relevant parties as required.
Complete your forms online to ensure timely processing and compliance with Iowa laws.
Agency: Iowa Department of Health and Human Services Changes included could be income, address, rent/utility payments, household members, etc. Call 1-877-347-5678 or Fax 515-564-4041.
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