DSHS Form 13-734 Documentation of First Use of Medicaid Benefits (Dda) - Washington (Lao)

DSHS Form 13-734 Documentation of First Use of Medicaid Benefits (Dda) - Washington (Lao)

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.

The document is provided in Lao. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 13-734?A: DSHS Form 13-734 is a documentation form used to record the first use of Medicaid benefits for DDA (Developmental Disabilities Administration) in Washington.

Q: Who is DSHS?A: DSHS stands for the Washington State Department of Social and Health Services, the agency responsible for administering the state's social and health programs.

Q: What is DDA?A: DDA stands for Developmental Disabilities Administration, which provides services and supports to individuals with intellectual and developmental disabilities in Washington.

Q: Why is DSHS Form 13-734 used?A: DSHS Form 13-734 is used to document and track the first use of Medicaid benefits for individuals receiving services through DDA.

Q: Who needs to fill out DSHS Form 13-734?A: The individual or their authorized representative, along with their DDA case manager, are responsible for filling out DSHS Form 13-734.

Q: What information is required on DSHS Form 13-734?A: DSHS Form 13-734 requires information such as the individual's name, date of birth, Medicaid identification number, and details about their first use of Medicaid benefits.

Q: Is DSHS Form 13-734 available in other languages?A: Yes, DSHS Form 13-734 is available in multiple languages, including Lao language for the convenience of Lao-speaking individuals.

Q: What should I do if I have trouble filling out DSHS Form 13-734?A: If you need assistance or have questions about filling out DSHS Form 13-734, you can contact your DDA case manager or reach out to the Washington State Department of Social and Health Services for support.

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Form Details:

  • Released on June 1, 2008;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of DSHS Form 13-734 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.

Download DSHS Form 13-734 Documentation of First Use of Medicaid Benefits (Dda) - Washington (Lao)

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