Alaska Department of Health and Social Services Forms
Documents:
402
This Form is used for reviewing eligibility for a particular program in Alaska.
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This form is used for verifying a diagnosis in Alaska.
This document provides a checklist for the initial application process for becoming a Certified Financial Counselor (CFC) in Alaska.
This Form is used for recording activity details of clients receiving general relief in assisted living homes in Alaska.
This document is used for creating a contract between a recipient and a provider agency for Consumer Directed Personal Care services in Alaska.
This Form is used for understanding the rights and responsibilities of recipients in Alaska. It helps individuals understand the rights they have and the responsibilities they must fulfill while receiving services.
This form is used for completing a questionnaire for initial and renewal support plans in Alaska. It helps gather necessary information for support plans.
This Form is used for applying for personal care services in the state of Alaska.
This form is used for making an appointment to receive Care Coordination/Targeted Case Management Services in Alaska.
This form is used for verifying the diagnosis of traumatic and acquired brain injuries in Alaska.
This Form is used for property owners in Alaska to give their consent for environmental modifications.
This document is for designating a representative for Personal Care Services or Community First Choice Personal Care Services in Alaska.
This Form is used for requesting a waiver of in-person review of services in Alaska.
This document is a checklist used by care coordinators in Alaska to request inquiries about CFC (Child and Family Connections) providers.
This form is used for creating a 24-hour care calendar in Alaska. It helps in organizing and scheduling care for individuals who require around-the-clock assistance.
