We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Request For Outreach Activity/event Procedure - Dhhr - Dhhr Wv

Get Request For Outreach Activity/event Procedure - Dhhr - Dhhr Wv

Ch can be accessed on the DSHH s website at www.wvstd.org or www.wvhiv.org and on the Office of Laboratory Services (OLS) website www.wvdhhr.org/labservices. Support services include provision of Aptima test kits for Chlamydia and gonorrhea testing; Orasure test kits for HIV testing and/or Rapid HIV testing per Disease Intervention Specialist(s) (DIS); supplies for syphilis testing; hepatitis A, B and A/B vaccine (without the prerequisite hepatitis testing); laboratory analysis of specimens.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

SNAP Outreach Activities FY23 State Plan
Aug 1, 2022 — SUBRECIPIENT GRANTEE INFORMATION FORM-WV DHHR FINANCE A-1000: Complete and...
Learn more
Field Education Office Sample Learning Contract...
Demonstrate Ethical & Professional Behavior. Prepare a presentation to be used as a part...
Learn more
Wv dhhr food stamps online application
... West Virginia Food Stamps (SNAP) program is a fairly easy process which can be done...
Learn more

Related links form

Verizon Adjudication Form Msprc Forms Affivavit Cash Receipt Template Form

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

Go to .wvmmis.com and click "Sign In" at the top of the page. Enter your username and password. If you do not have internet access, your health care provider can confirm your Medicaid eligibility. If you have any questions, contact your case worker or the DHHR Customer Service Center at 1-877-716-1212.

Explore Medicaid benefits and added services. ... Behavioral and mental health. Care management. Chronic disease management. Dental care. Health programs. Pharmacy and prescription drugs. Pregnancy care.

To check your status, you can log in to your account at commonhelp.virginia.gov by clicking the Check My Benefits button or call 1-855-242-8282 (TDD: 1-888-221-1590).

Income & Asset Limits for Eligibility 2024 West Virginia Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleMarried (one spouse applying)Medicaid Waivers / Home and Community Based Services$2,829 / month$2,829 / month for applicantRegular Medicaid / Aged, Blind or Disabled$943 / month$1,415 / month2 more rows • Nov 27, 2023

Employer and income info: household monthly income, pay stubs and W-2 forms. Social Security numbers or document numbers for each household member applying. Date of birth for each household member applying. Immigration info, if it applies (some noncitizens may qualify to enroll, depending on state rules)

Proof of citizenship and immigration status (birth certificate, military records, U.S. Passport, Naturalization Certificate, permanent resident card/Green card). Proof of Social Security Number (Social Security Card, photo ID with birthdate so social worker can look up your Social Security Number).

How do I report changes to Customer Services? By phone: 1-877-716-1212; e-mail: dhhrbcfchangectr@wv.gov; fax: 304-558-1869; and U.S. Postal Service: P.O. Box 1668, Charleston, WV 25326-1668. You can also report changes, apply for benefits and complete reviews at .wvpath.org.

Need to update your info? Online: Log in or create an Optum GovID at WV Path. Then, choose My Changes to report any changes to your info. By phone: Call 1-877-716-1212 to contact your DHHR caseworker.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get REQUEST FOR OUTREACH ACTIVITY/EVENT PROCEDURE - DHHR - Dhhr Wv
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232