This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form HCA13-870?A: Form HCA13-870 is a Limitation Extension Request for Incontinent Supplies and Gloves in Washington.
Q: What does this form do?A: This form is used to request an extension for the limitation on incontinent supplies and gloves in Washington.
Q: Who needs to fill out this form?A: Individuals in Washington who require incontinent supplies and gloves and need an extension on the limitation must fill out this form.
Q: What information is required on this form?A: The form requires personal information, medical condition details, and a statement explaining the need for the extension.
Q: Are there any fees associated with this request?A: No, there are no fees associated with submitting this request.
Q: How long does the extension last?A: The length of the extension granted will depend on the individual's medical condition and the evaluation by the healthcare authority.
Form Details:
Download a fillable version of Form HCA13-870 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.