Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc / Cdpcs) Recipient and Cdpcs or Cfc / Cdpcs Provider Agency Contract - Alaska

Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc / Cdpcs) Recipient and Cdpcs or Cfc / Cdpcs Provider Agency Contract - Alaska

What Is Form CFC-04 (PCA-07)?

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

FAQ

Q: What is Form CFC-04 (PCA-07)?
A: Form CFC-04 (PCA-07) is a contract used in Alaska for Consumer Directed Personal Care Services (CDPCS) and Community First Choice Consumer Directed Personal Care Services (CFC/CDPCS) recipients and CDPCS or CFC/CDPCS provider agencies.

Q: Who uses Form CFC-04 (PCA-07)?
A: Form CFC-04 (PCA-07) is used by recipients of CDPCS and CFC/CDPCS services in Alaska, as well as the provider agencies for these services.

Q: What is the purpose of Form CFC-04 (PCA-07)?
A: Form CFC-04 (PCA-07) is used to establish and document the contractual agreement between the recipient of CDPCS or CFC/CDPCS services and the provider agency.

Q: Are there any other similar forms for CDPCS and CFC/CDPCS services in Alaska?
A: Yes, there are other forms such as forms for enrollment, assessment, and authorization of services in the CDPCS and CFC/CDPCS programs. These forms may vary depending on the specific requirements of the program.

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Form Details:

  • Released on February 20, 2020;
  • The latest edition provided by the Alaska Department of Health and Social 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 CFC-04 (PCA-07) by clicking the link below or browse more documents and templates provided by the Alaska Department of Health and Social Services.

Download Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc / Cdpcs) Recipient and Cdpcs or Cfc / Cdpcs Provider Agency Contract - Alaska

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  • Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc/Cdpcs) Recipient and Cdpcs or Cfc/Cdpcs Provider Agency Contract - Alaska

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  • Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc/Cdpcs) Recipient and Cdpcs or Cfc/Cdpcs Provider Agency Contract - Alaska, Page 2

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  • Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc/Cdpcs) Recipient and Cdpcs or Cfc/Cdpcs Provider Agency Contract - Alaska, Page 3

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  • Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc / Cdpcs) Recipient and Cdpcs or Cfc / Cdpcs Provider Agency Contract - Alaska, Page 1
  • Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc / Cdpcs) Recipient and Cdpcs or Cfc / Cdpcs Provider Agency Contract - Alaska, Page 2
  • Form CFC-04 (PCA-07) Consumer Directed Personal Care Services (Cdpcs) and Community First Choice Consumer Directed Personal Care Services (Cfc / Cdpcs) Recipient and Cdpcs or Cfc / Cdpcs Provider Agency Contract - Alaska, Page 3
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