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Get Wa Dshs 15-449 2015-2025
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How to fill out the WA DSHS 15-449 online
The WA DSHS 15-449 form is essential for providing information regarding charges and services at an adult family home. This guide will walk you through each section of the form, ensuring a successful and efficient completion.
Follow the steps to fill out the form accurately.
- Click ‘Get Form’ button to access the online document and load it in the editor.
- Begin with the section labeled 'Home / Provider’s name'. Input the name of the adult family home you are inquiring about.
- Next, fill in the 'Date' field with the date you are completing the form.
- Enter the 'License number' provided for the adult family home to confirm its legitimacy.
- Review the 'Medicaid Information' section to understand payment policies regarding Medicaid acceptance and any monitoring requirements.
- In the 'Admission Fee' section, disclose any admission fees required by the home. Provide the fee amount and any additional comments regarding these charges.
- Complete the 'Deposits' section by detailing any required deposits, including the purpose and amount for each.
- Moving on to 'Prepaid Charges', list any prepayment requirements along with the purpose for each charge.
- Document any 'Other Fees / Charges' that apply, providing the purpose and amounts.
- In the 'Daily and/or Monthly Rates', record the low and high rates charged by the home for care, services, and room.
- Provide information regarding 'Personal Care', 'Medication Services', and 'Other Services'. Note any additional charges applicable for different levels of personal assistance.
- Continue to fill out the 'Items' and 'Activities' sections, listing customarily available items and activities along with their associated charges.
- Lastly, save any changes made, download the filled form, print it for your records, or share it with relevant parties as necessary.
Complete your documents online today to ensure you have the most accurate and up-to-date information.
Submitting documents to the Department of Human Services (DHS) is quite similar to DSHS submission processes. Start by determining the necessary forms and the specific DHS office related to your case. You can often submit these documents online, by fax, or by traditional mail. Consult the WA DSHS 15-449 information for tips on compiling and sending your documentation efficiently.
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