Alaska Department of Health and Social Services Forms

This form is used for requesting direct deposit of funds in Alaska.

This form is used for amending the service plan in Alaska.

This document provides a checklist for the required documents needed for the SDS Waiver Policy 3-7 on complete applications in Alaska. It ensures that all necessary paperwork is submitted correctly for the waiver policy.

This form is used for creating a shared agency service agreement in Alaska.

This form is used for certification of Home and Community-Based Services in Alaska. It includes policies, procedures, and compliance attestation.

This form is used for applying for a marriage license in the state of Alaska.

This document is used for designating an administrator, designee, or resident manager in the state of Alaska.

This document is a self-monitoring inspection report used in Alaska. It is used to assess compliance with regulations and standards in various industries.

This form is used for authorizing the release of information in the state of Alaska. It is used when someone wants to give permission for their private information to be shared with a third party.

This form is used for applying for the Community First Choice (CFC) program in Alaska.

This form is used for requesting passive range of motion services for personal care in Alaska.

This form is used for individual providers in Alaska to agree to the privacy and security policies of the Harmony Data System.

This Form is used for the initial, renewal, or interim application for an ISW/IDD license in Alaska. It serves as a checklist to ensure that all necessary documents and requirements are submitted correctly.

This form is used for requesting an exception for a day habilitation setting in Alaska.

This Form is used for applying for a developmental disability determination in Alaska.

This document is used for notifying the transfer of a child in Alaska. It is required by the Alaska Child Support Services Division.