Form DSS-EA-265 Request for Long-Term Care or Home Community Based Services Waiver Assistance - South Dakota

Form DSS-EA-265 Request for Long-Term Care or Home Community Based Services Waiver Assistance - South Dakota

What Is Form DSS-EA-265?

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

FAQ

Q: What is form DSS-EA-265?A: Form DSS-EA-265 is a request for Long-Term Care or Home Community Based Services Waiver Assistance in South Dakota.

Q: What does the form request?A: The form requests Long-Term Care or Home Community Based Services Waiver Assistance.

Q: Who can use this form?A: Any individual in South Dakota who is in need of Long-Term Care or Home Community Based Services Waiver Assistance can use this form.

Q: Is there a fee for submitting this form?A: No, there is no fee for submitting this form.

Q: What information do I need to provide on this form?A: You will need to provide personal information, income and asset information, and details about your need for Long-Term Care or Home Community Based Services.

Q: How long does it take to process this form?A: The processing time for this form varies, but you should receive a response within a few weeks.

Q: What should I do if I have questions or need assistance with this form?A: If you have questions or need assistance with this form, you can contact your local county office or the South Dakota Department of Social Services for help.

Q: What happens after I submit this form?A: After you submit this form, it will be reviewed by the South Dakota Department of Social Services to determine your eligibility for Long-Term Care or Home Community Based Services Waiver Assistance.

Q: Is there a deadline for submitting this form?A: There is no specific deadline for submitting this form, but it is recommended to submit it as soon as possible to receive timely assistance.

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Form Details:

  • Released on October 1, 2022;
  • The latest edition provided by the South Dakota Department of Social Services;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DSS-EA-265 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.

Download Form DSS-EA-265 Request for Long-Term Care or Home Community Based Services Waiver Assistance - South Dakota

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