Get Sc Dhec 1534 2017-2025

The SC DHEC 1534 form is essential for applicants seeking assistance through the Direct Dispensing Program (DDP). This guide will walk you through the necessary steps to complete the form accurately online.

Follow the steps to fill out the SC DHEC 1534 correctly.

1. Press the ‘Get Form’ button to access the SC DHEC 1534 form online.
2. Begin by entering your applicant information. Include your last name, first name, and full middle name, along with your date of birth and Social Security number. If you do not have a Social Security number, indicate your length of residence in South Carolina.
3. Provide your home address and county. If your mailing address differs from your home address, list it accordingly. Make sure to include a contact number where you can be reached.
4. In the ethnicity and race sections, check the appropriate boxes that reflect your background. This information is valuable for DDP processing.
5. For eligibility information, list the members of your household along with their relationship to you, gender, date of birth, place of employment, and estimated yearly gross income. Ensure to include supporting documentation, if necessary.
6. In the certification/consent section, read each statement and provide your signature and the date to confirm your understanding and agreement.
7. If applicable, the benefits information section should be completed by a case manager or physician. Ensure they check the appropriate boxes regarding insurance and coverage.
8. For the clinical information section, a physician will complete necessary details about your medical status. Ensure all required signatures are obtained.
9. Once all sections are completed, review the form for accuracy before saving the changes. You can then download, print, or share the completed form as required.

Begin filling out your SC DHEC 1534 form online today!