Form OHIP-0103 Attestation of Immediate Need for Personal Care Services / Consumer Directed Personal Assistance Services - New York

Form OHIP-0103 Attestation of Immediate Need for Personal Care Services / Consumer Directed Personal Assistance Services - New York

What Is Form OHIP-0103?

This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form OHIP-0103?A: Form OHIP-0103 is an attestation form for immediate need for personal care services/consumer directed personal assistance services in New York.

Q: What does this form attest to?A: This form attests to the immediate need for personal care services/consumer directed personal assistance services.

Q: Who should use this form?A: This form should be used by individuals who have an immediate need for personal care services or consumer directed personal assistance services in New York.

Q: What information is required in the form?A: The form requires personal information, details of the immediate need, and signatures of the individual and the attesting professional.

Q: What is the purpose of this form?A: The purpose of this form is to certify the immediate need for personal care services or consumer directed personal assistance services.

Q: How should I submit the form?A: You can submit the completed form to the New York State Department of Health or the designated agency for your area.

Q: Is there a deadline for submitting the form?A: There may be a deadline for submitting the form, so it is important to check with the appropriate agency for the specific requirements.

Q: Can I get assistance in filling out this form?A: Yes, you may seek assistance from a healthcare professional or an organization that provides personal care services or consumer directed personal assistance services.

Q: Are there any fees associated with this form?A: There may be fees associated with personal care services or consumer directed personal assistance services, but the form itself does not require a fee.

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Form Details:

  • Released on August 1, 2016;
  • The latest edition provided by the New York State Department of Health;
  • 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 printable version of Form OHIP-0103 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.

Download Form OHIP-0103 Attestation of Immediate Need for Personal Care Services / Consumer Directed Personal Assistance Services - New York

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