Form DHS-54A Medical Needs - Michigan

Form DHS-54A Medical Needs - Michigan

What Is Form DHS-54A?

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

FAQ

Q: What is the Form DHS-54A?A: The Form DHS-54A is a Medical Needs form used in Michigan.

Q: What is the purpose of Form DHS-54A?A: The purpose of Form DHS-54A is to identify and document the medical needs of a person receiving services from the Michigan Department of Health and Human Services (DHHS).

Q: Who uses Form DHS-54A?A: Form DHS-54A is used by individuals who require medical assistance or services from the Michigan DHHS.

Q: What information is needed on Form DHS-54A?A: Form DHS-54A requires the individual's personal and contact information, medical history, medications, treatments, and any other relevant medical information.

Q: Is Form DHS-54A confidential?A: Yes, the information provided on Form DHS-54A is confidential and protected under privacy laws.

Q: Do I need to renew Form DHS-54A?A: Yes, Form DHS-54A needs to be renewed every year or when there are significant changes in the individual's medical needs.

Q: Are there any fees associated with Form DHS-54A?A: No, there are no fees associated with submitting Form DHS-54A.

Q: What if I need help filling out Form DHS-54A?A: If you need assistance in completing Form DHS-54A, you can contact your local DHHS office or seek help from a trusted healthcare provider or social worker.

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Form Details:

  • Released on June 1, 2015;
  • The latest edition provided by the Michigan 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 Form DHS-54A by clicking the link below or browse more documents and templates provided by the Michigan Department of Health and Human Services.

Download Form DHS-54A Medical Needs - Michigan

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  • Form DHS-54A Medical Needs - Michigan, Page 1
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