Get Lpcrules09 - Texas Department Of State Health Services

Filling out the Lpcrules09 form is essential for program certification with the Texas Department of State Health Services. This guide provides a clear, step-by-step approach to assist users in completing the form accurately and efficiently.

Follow the steps to successfully complete your application

1. Click ‘Get Form’ button to obtain the application form and open it in the editor.
2. Enter the program name at the designated field provided on the form. Ensure the name is concise and accurately reflects your program's purpose.
3. Fill out the contact information including fax number, mailing address, city, state, zip code, telephone number, and email contact. Double-check each entry for accuracy.
4. List the names of all direct treatment staff involved in your program. Each name must be entered clearly and correctly in the appropriate section.
5. Indicate the staff level requested for each staff member listed. This should be based on the qualifications and roles of your staff within the program.
6. Confirm your program's compliance with the relevant sections of the Washington Administrative Code by checking the applicable boxes. Be thorough in your review to ensure all relevant standards are met.
7. Indicate your consent for an on-site review of program files by checking the 'Yes' or 'No' options. Understanding the implications of this consent is crucial.
8. As the program director, certify that all provided information is true and correct by signing in the designated area. Additionally, print your name and include the date of signing.
9. Review the entire application for completeness and accuracy. Once you are confident it is filled out correctly, save any changes you have made.
10. Finally, you may download, print, or share the completed form as required for submission to the Department of Social and Health Services.

Complete your documents online and ensure your application is accurately submitted.