Get Ia Form 470-3158 2014-2025

Completing the IA Form 470-3158 online is an important step for individuals seeking assistance from the Iowa Department of Human Services. This guide provides clear instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the IA Form 470-3158.

1. Press the 'Get Form' button to access the IA Form 470-3158 and open it in the online form editor.
2. Enter the date at the top right corner of the form to indicate when the information is being provided.
3. Fill in the payor's name in the designated field. Ensure spelling is accurate to avoid any processing delays.
4. Provide the patient's name in the 'Patient Name' field. Use the format specified, as this will be required for identification purposes.
5. Indicate the payor's relationship to the patient in the corresponding field, as this information is necessary for context in the case.
6. Input the case number assigned to your situation in the 'Case Number' field, ensuring it matches any documentation you have.
7. Include the contact information for the Child Support Recovery Unit. Fill in the address and phone number as indicated. This is crucial for correspondence.
8. In the consent section, ensure the patient signs and dates where required, authorizing the release of their medical information.
9. If the patient is a minor or unable to sign, the legal guardian must sign in the appropriate section.
10. Review all information for accuracy. Make any necessary adjustments before finalizing the document.
11. Once completed, choose to save your changes. You may also opt to download, print, or share the form as needed.

Complete your IA Form 470-3158 online today to ensure efficient processing of your request.