Follow the steps to accurately fill out the Pae Form online.

1. Click the ‘Get Form’ button to access the Pae Form and open it in the editor.
2. Begin by entering the applicant's name in the designated fields. Make sure to include the last name, first name, and middle name.
3. Provide the applicant's date of birth in the specified format. This is essential for identifying the individual.
4. Fill out the applicant's street address, including county, city, state, and zip code.
5. Identify a designee if applicable, who will receive information regarding the application. Enter their name, address, and phone number.
6. Check the appropriate boxes to indicate the service requested, such as HCBS, and any applicable target groups.
7. Select the appropriate cost neutrality caps based on the applicant's needs and the type of submission request being made.
8. Complete the assessment sections for the applicant's capabilities, such as transfer, mobility, eating, toileting, and communication. Provide as much detail as possible.
9. If applicable, indicate any required skilled nursing or rehabilitative services, including frequency and the necessary supporting documentation.
10. Finally, review all entries for accuracy. Save your changes, download, or print the completed form for submission.

Start filling out the Pae Form online today to ensure timely processing of your application.