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Get Ia Dhs 470-3372 2015-2025
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How to fill out the IA DHS 470-3372 online
The IA DHS 470-3372 form is essential for establishing a Consumer-Directed Attendant Care agreement between a Medicaid waiver member and their chosen care provider. This guide will help you navigate the online form, ensuring you accurately provide all required information for effective service delivery.
Follow the steps to fill out the form correctly.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter the name of the member for whom the services will be provided in the designated field.
- Provide the name of the CDAC provider in the appropriate section.
- Detail the services required by the member, specifying the number of units and the payment rate agreed upon by all parties.
- Ensure that the member or their legal representative and the CDAC provider sign and date the agreement, confirming approval of the information presented.
- Document the plan for emergencies, including emergency contacts and procedures.
- Confirm the necessary standards met by the CDAC provider, including age and skills, through the provided checkboxes.
- Detail the various service activities and their required frequencies as instructed.
- Upon completion, review all entered information for accuracy and coherence.
- Save changes, download, print, or share the completed form as needed.
Start filling out your IA DHS 470-3372 form online today!
To apply for an elderly waiver in Iowa, you first need to contact your local Department of Human Services office. They can guide you through the application process, including the necessary forms and documents related to IA DHS 470-3372. Be prepared to provide information about your medical needs and financial situation to help streamline your application.
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