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This version of the form is not currently in use and is provided for reference only. Download this version of
DHHS Form 1716
for the current year.
DHHS Form 1716 Request for Medicaid Id Number - Infant - South Carolina
What Is DHHS Form 1716?
This is a legal form that was released by the South Carolina Department of Health and Human Services - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DHHS Form 1716?
A: DHHS Form 1716 is a form used to request a Medicaid ID number for an infant in South Carolina.
Q: Who uses DHHS Form 1716?
A: Parents or legal guardians of an infant in South Carolina who need a Medicaid ID number use DHHS Form 1716.
Q: What is the purpose of DHHS Form 1716?
A: The purpose of DHHS Form 1716 is to request a Medicaid ID number for an infant in South Carolina, which is required to access Medicaid benefits.
Q: Is DHHS Form 1716 specific to South Carolina?
A: Yes, DHHS Form 1716 is specific to South Carolina and is used for requesting a Medicaid ID number for an infant in the state.
Q: Are there any fees associated with DHHS Form 1716?
A: No, there are no fees associated with submitting DHHS Form 1716 to request a Medicaid ID number for an infant in South Carolina.
Form Details:
- Released on August 1, 2015;
- The latest edition provided by the South Carolina Department of Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of DHHS Form 1716 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Health and Human Services.
