Fill and Sign United States Legal Forms

This form is used for mandatory groups in Mississippi to request a change of plan.

This form is used for enrolling in mandatory groups in the state of Mississippi.

This Form is used for enrolling in optional groups in the state of Mississippi.

This form is used for 5-10 years old children's EPSDT visit in Mississippi.

This form is used for children aged 1-4 to schedule an EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) visit in Mississippi.

This form is used for EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) visits for individuals aged 11-21 in Mississippi. It is a required form for eligible individuals to receive comprehensive health services.

This form is used for submitting inquiries or complaints in the state of Mississippi.

This form is used for requesting a speaker in the state of Mississippi.

This Form is used for requesting a reconsideration of a claim in the state of Mississippi. It allows individuals to submit additional information or evidence to support their claim.

This document is used to report any changes in insurance coverage to the Mississippi Medicaid program.

This Form is used for making changes to the original plan for optional groups in Mississippi.

This form is used for making initial referrals in the state of Mississippi for the Child Protective Services.

This document is an addendum to the Provider Application and Agreement for Nursing Facility Ventilator Dependent Care (VDC) Services in Mississippi.

This form is used for general inquiries in the state of Mississippi.

This form is used for submitting an A-B Election Notice in the state of Mississippi.

This document is an application form used for applying to the State of Mississippi.

This document is a form used in Mississippi to certify the return or destruction/sanitization of confidential data as part of a data use agreement.

This form is used for submitting a notice of change in Michigan.

This form is a coupon used as payment transmittal when paying the state Unemployment Insurance (UI) tax, one of Michigan's taxes that employers must pay.

This document is a student agreement specific to Michigan colleges/universities related to COVID-19 protocols and safety measures.

This form is used for Michigan residents who are attending community college and need to request their unemployment insurance data using their Social Security Number (SSN). This document is specific to residents of Michigan.

This form is used for requesting unemployment insurance data related to Michigan community colleges.

This form is used for granting someone else the authority to make legal decisions on your behalf in the state of Michigan.

This document is used to report apparent violations of the Migrant and Seasonal Agricultural Worker Protection Act in the state of Michigan.

This Form is used for requesting an extension for the 21-day eligibility period for the Path 21-day Application in Michigan.

This document outlines the plan for the 21-day application eligibility period in Michigan for the Path Week 3 Assignment.

This document outlines the plan for the first week of the Path program and explains the 21-day application eligibility period in Michigan.

This document outlines the plan for the second week of the PATH program in Michigan. It includes information about the 21-day application eligibility period.

This form is used for reporting a supplemental report of a fatal injury in the state of Michigan.

This form is used for healthcare providers in Michigan to report a claim and request payment for medical services rendered.