WebAbout DHS. Our mission is to assist Pennsylvanians in leading safe, healthy, and productive lives through equitable, trauma-informed, and outcome-focused services while being an accountable steward of commonwealth resources. WebContact Us. MA & CHIP Renewals. Apply for Benefits. COVID-19. Report Fraud & Abuse. Licensing & Providers. Department of Human Services > Find a Document > Forms. Find a form tool.
Authorization to Release Confidential Information - MPHI
WebYou will also need to sign Authorization to Release Protected Health Information (DHS 1555) and Reimbursement Authorization (DHS 3975). Your caseworker will give you all of these forms after you turn in your SDA application. ... You can also call MI Bridges at 888-642-7434 or use DHS Form-2240 to report changes. It is best to report changes in ... inbound phone software
Juvenile Justice Reentry Care Coordination Referral Form
WebStudy with Quizlet and memorize flashcards containing terms like MiTEAM, What is Michigan's case practice model called?, What is the goal of the MiTEAM practice model? and more. ... DHS - 1555 - CS. What form do we need to send to Friend do the Court as a warning of removal? DHS 729. What are the four types of information? 1. Facts/Evidence … WebTop. If you have a question about whether or not you are eligible for SER, or if you feel you have been wrongly denied or aren't getting the right amount, you may be able to get help from the Counsel and Advocacy Law Line. This is a free legal aid hotline. To find out if they can help you, apply online or call 1-888-783-8190 Monday - Thursday ... Webask the family to sign the DHS-1555-CS, Authorization to Release Confidential Information. Completion of the DHS-1555-CS allows DHS to receive the Early On evaluation results and any plan for services, if applicable. MiSACWIS CPS will prompt workers to complete a referral to Early On when required. When inbound planning 1.1