Document Tag: Form
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DHB-2192 SSA Training Form – County Staff and County Contract Staff
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DHB-2193 Memorandum of CAP Waiver Enrollment
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DHB-2194 IRC Rules Handout
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DHB-2195 Documentation of Annual Security Training Confidentiality Form – County Staff
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DHB-2055 Reimbursement for Medical Transportation
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DHB-2056 Purchased Medical Transportation Costs
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DHB-2190 Internal Inspection Report
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DHB-2191 Designation of Control Officer for FRR/Beer Reports
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DHB-2045 Instructions for Completing Medicaid Credit Balance Report
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DHB-2050 Voluntary Request to Terminate Medicaid