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182
![Form HCSP-M11Q "Medical Request for Home Care" - New York City](https://data.templateroller.com/pdf_docs_html/1999/19995/1999521/form-hcsp-m11q-medical-request-for-home-care-new-york-city.png "Form HCSP-M11Q "Medical Request for Home Care" - New York City")
Form HCSP-M11Q "Medical Request for Home Care" - New York City
Size: 85 KB
4 pages
This is a document that is used in the state of New York to apply for personal home care and contains information regarding the patient's medical condition.
![Form OCS-1 "Authorization to Release Case Information" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20718/2071811/form-ocs-1-authorization-to-release-case-information-new-york-city.png "Form OCS-1 "Authorization to Release Case Information" - New York City")
![Form DSS-14 "Special Supplemental Assistance Fund Claim Request Form" - New York City](https://data.templateroller.com/pdf_docs_html/2092/20927/2092748/form-dss-14-special-supplemental-assistance-fund-claim-request-form-new-york-city.png "Form DSS-14 "Special Supplemental Assistance Fund Claim Request Form" - New York City")
![Form DSS-8B "Tenant Contact Information" - New York City](https://data.templateroller.com/pdf_docs_html/2072/20720/2072011/form-dss-8b-tenant-contact-information-new-york-city.png "Form DSS-8B "Tenant Contact Information" - New York City")
![Form DSS-8E "Cityfheps Verification of Eligibility" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20719/2071901/form-dss-8e-cityfheps-verification-of-eligibility-new-york-city.png "Form DSS-8E "Cityfheps Verification of Eligibility" - New York City")
![Form DSS-8I "Cityfheps Packet Cover Sheet - Community" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20719/2071902/form-dss-8i-cityfheps-packet-cover-sheet-community-new-york-city.png "Form DSS-8I "Cityfheps Packet Cover Sheet - Community" - New York City")
![Form DSS-8H "Cityfheps Packet Cover Sheet - Shelter" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20718/2071882/form-dss-8h-cityfheps-packet-cover-sheet-shelter-new-york-city.png "Form DSS-8H "Cityfheps Packet Cover Sheet - Shelter" - New York City")
![Form DSS-8K "Change of Payee for Cityfheps Payments" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20719/2071926/form-dss-8k-change-of-payee-for-cityfheps-payments-new-york-city.png "Form DSS-8K "Change of Payee for Cityfheps Payments" - New York City")
![Form DSS-8G "Cityfheps Landlord Information Form - Room and Sro Rentals" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20719/2071932/form-dss-8g-cityfheps-landlord-information-form-room-and-sro-rentals-new-york-city.png "Form DSS-8G "Cityfheps Landlord Information Form - Room and Sro Rentals" - New York City")
![Form DSS-8F "Cityfheps Landlord Information Form - Apartment Rentals" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20719/2071927/form-dss-8f-cityfheps-landlord-information-form-apartment-rentals-new-york-city.png "Form DSS-8F "Cityfheps Landlord Information Form - Apartment Rentals" - New York City")
![Form SNT-12 "Supplemental Needs Trust Accounting" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20718/2071862/form-snt-12-supplemental-needs-trust-accounting-new-york-city.png "Form SNT-12 "Supplemental Needs Trust Accounting" - New York City")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071943/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-russian.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Russian)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071942/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-korean.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Korean)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Chinese Simplified)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071939/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-chinese-simplified.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Chinese Simplified)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Chinese)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071938/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-chinese.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Chinese)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Polish)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071947/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-polish.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Polish)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Urdu)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071948/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-urdu.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Urdu)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071944/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-bengali.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Bengali)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Arabic)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071945/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-arabic.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Arabic)")
![Form DSS-7S "Demande De Modification Du Montant De Votre Aide Supplementaire Au Logement Cityfheps" - New York City (French)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071946/form-dss-7s-demande-de-modification-du-montant-de-votre-aide-supplementaire-au-logement-cityfheps-new-york-city-french.png "Form DSS-7S "Demande De Modification Du Montant De Votre Aide Supplementaire Au Logement Cityfheps" - New York City (French)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City](https://data.templateroller.com/pdf_docs_html/2071/20719/2071937/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City")
![Formulario DSS-7S "Peticion Para Modificar La Cantidad Del Suplemento De Asistencia De Alquiler De Cityfheps" - New York City (Spanish)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071940/formulario-dss-7s-peticion-para-modificar-la-cantidad-del-suplemento-de-asistencia-de-alquiler-de-cityfheps-new-york-city-spanish.png "Formulario DSS-7S "Peticion Para Modificar La Cantidad Del Suplemento De Asistencia De Alquiler De Cityfheps" - New York City (Spanish)")
![Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Haitian Creole)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071941/form-dss-7s-request-for-a-modification-to-your-cityfheps-rental-assistance-supplement-amount-new-york-city-haitian-creole.png "Form DSS-7S "Request for a Modification to Your Cityfheps Rental Assistance Supplement Amount" - New York City (Haitian Creole)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071876/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-bengali.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Bengali)")
Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Bengali)
Size: 207 KB
4 pages
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Haitian Creole)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071869/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-haitian-creole.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Haitian Creole)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Polish)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071874/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-polish.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Polish)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071878/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-russian.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Russian)")
Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Russian)
Size: 217 KB
4 pages
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071870/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-korean.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Korean)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (French)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071873/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-french.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (French)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Chinese Simplified)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071868/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-chinese-simplified.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Chinese Simplified)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Arabic)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071877/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-arabic.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Arabic)")
![Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Chinese)](https://data.templateroller.com/pdf_docs_html/2071/20718/2071867/form-dss-7p-cityfheps-program-participant-agreement-new-york-city-chinese.png "Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Chinese)")
Form DSS-7P "Cityfheps Program Participant Agreement" - New York City (Chinese)
Size: 198 KB
4 pages
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Arabic)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071929/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-arabic.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Arabic)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071921/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-bengali.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Bengali)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Bengali)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071913/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-bengali.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Bengali)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071909/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-korean.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Korean)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Urdu)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071923/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-urdu.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Urdu)")
![Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Korean)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071917/form-dss-7o-application-for-cityfheps-rooms-only-new-york-city-korean.png "Form DSS-7O "Application for Cityfheps (Rooms Only)" - New York City (Korean)")
![Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Russian)](https://data.templateroller.com/pdf_docs_html/2071/20719/2071916/form-dss-7q-application-for-cityfheps-apartments-and-single-room-occupancy-units-new-york-city-russian.png "Form DSS-7Q "Application for Cityfheps (Apartments and Single Room Occupancy Units)" - New York City (Russian)")
