Get Mi Dhs-54a 2008-2025
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the MI DHS-54A online
The MI DHS-54A form is an essential document required by the Michigan Department of Health and Human Services, to assess the medical needs of recipients and their eligibility for services. This guide will provide step-by-step instructions on how to complete this form online effectively.
Follow the steps to fill out the MI DHS-54A form online:
- Click the ‘Get Form’ button to access the MI DHS-54A form and open it in your preferred online environment.
- Begin by entering the patient's name, birth date, and the case number, which are essential for identifying the individual requiring assistance.
- Provide the recipient ID number, which helps to further track the patient's records and ensure accurate service provision.
- Specify the medical provider's details, including the specialist's name, contact number, and office address, ensuring all fields are completed legibly.
- In Section A, indicate the pregnancy delivery date if applicable and the number of medically verified unborn children, as this information is crucial for specific care services.
- In Section B, outline any diagnosed conditions and the corresponding treatment plan that is necessary for the patient's care.
- Sections C through K will require you to answer questions regarding the patient's mobility, need for special transportation, and assistance with personal care activities. Be honest and thorough in your responses to ensure proper support.
- For complex care services needed (Section L), check all applicable options and provide specifics whenever necessary.
- Complete the signature section at the bottom of the form, which includes spaces for both the patient or their representative and the authorized specialist. Ensure to include the date next to each signature.
- Once you have filled out the form completely, review all entries for accuracy. Save your changes, download a copy of the completed form, or share it as needed to submit it to the relevant department.
Begin filling out your documents online today for a smoother process.
The income limit for food stamps in Michigan is determined by family size and the federal guidelines. The MI DHS-54A is essential for applying, as it collects information regarding household income and expenses. Typically, households must have an income at or below 200% of the federal poverty level to qualify. To find your specific eligibility, you can consult additional resources, such as those available on the USLegalForms platform.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.