This is a legal form that was released by the Illinois Department of Children and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form CFS578-4?
A: Form CFS578-4 is a request form to transfer licensing responsibility for a Home and Community-Based Services for the Medically Fragile/Technology Dependent Children program (HMR Home) in Illinois.
Q: What does the form request?
A: The form requests the transfer of licensing responsibility for the HMR Home program.
Q: Who should use Form CFS578-4?
A: This form should be used by individuals or entities requesting to transfer licensing responsibility for the HMR Home program in Illinois.
Q: Is there a fee for submitting this form?
A: There is no fee mentioned for submitting Form CFS578-4.
Download a fillable version of Form CFS578-4 by clicking the link below or browse more documents and templates provided by the Illinois Department of Children and Family Services.