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Get Ma Psi 2018-2025
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How to fill out the MA PSI online
Filling out the MassHealth Permission to Share Information (MA PSI) form online can be a straightforward process if you follow the right steps. This guide will provide clear, step-by-step instructions to help you complete the form accurately.
Follow the steps to successfully complete the MA PSI form online.
- Press the ‘Get Form’ button to access the MA PSI form and open it in your preferred digital platform.
- Begin by entering the name of the MassHealth applicant or member in Section 1. This is a crucial step as it identifies the individual whose information will be shared.
- In Section 2, indicate what information you want shared by checking the appropriate boxes. You may select one or more options that pertain to your request.
- Proceed to Section 3 and enter the name of the individual or organization with whom you wish to share your information. Remember, you can only list one entity here.
- In Section 4, explain why you want to share your information. This section can be left blank if your reason aligns with 'at my request'.
- Complete Section 5 by entering the street address, city, state, and zip code of the applicant or member. Additionally, include the date of birth and telephone number.
- If applicable, specify in Section 6 whether you permit the sharing of drug and alcohol treatment information by checking the corresponding box.
- Finally, sign and date the form in Section 7. If another individual is filling out the form on behalf of the applicant, ensure that their authority to act on behalf of the applicant is clear and provide any necessary legal documentation if required.
- After completing all sections, review the form for accuracy. You can then choose to save your changes, download the completed form, print it for mailing or faxing, or share it as needed.
Complete your MA PSI form online today to ensure your information is shared as needed!
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