PDF
Word
Form ODM02392 Designation of Authorized Representative for Home Care Attendant Services - Ohio
What Is Form ODM02392?
This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is ODM02392?A: ODM02392 is a designation form for authorized representatives for home care attendant services in Ohio.
Q: What is an authorized representative?A: An authorized representative is a person who is chosen by an individual to act on their behalf and make decisions related to their home care attendant services.
Q: Who needs to fill out ODM02392?A: Individuals who receive home care attendant services in Ohio and want to designate someone as their authorized representative need to fill out ODM02392.
Q: What is the purpose of ODM02392?A: The purpose of ODM02392 is to officially designate an authorized representative for home care attendant services in Ohio.
Q: Is ODM02392 mandatory?A: No, filling out ODM02392 is not mandatory, but it is a way to ensure that someone can make decisions on your behalf regarding your home care attendant services.
Q: What information is required on ODM02392?A: ODM02392 requires information about the individual receiving home care attendant services, as well as the information of the designated authorized representative.
Q: Can I change my authorized representative?A: Yes, you can change your authorized representative by filling out a new ODM02392 form and submitting it to the appropriate authorities.
Q: How long is ODM02392 valid for?A: ODM02392 is valid until it is revoked or a new form is submitted with updated information.
Q: Can I have multiple authorized representatives?A: Yes, you can have multiple authorized representatives, but each one needs to be designated individually on a separate ODM02392 form.
Form Details:
- Released on November 1, 2015;
- The latest edition provided by the Ohio Department of Medicaid;
- 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 ODM02392 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
