Fill and Sign Louisiana Legal Forms

This document is used for certifying terminal illness for individuals seeking hospice care under the Louisiana Medicaid Program in Louisiana.

This form is used for submitting a request for Medicaid subrogation in the state of Louisiana.

This document is a request form for Louisiana residents who qualify for Medicaid through the medically needy program and need to meet a spend-down requirement. It is used to notify the Medicaid provider about the need to spend down income or resources to qualify for medical coverage.

This document is for providers in Louisiana who need information on how to request a Spend-Down Medically Needy Notice. It provides instructions on the process and requirements for this request.

This document is used to request the deduction of incurred medical expenses under the Medicaid program in Louisiana.

This Form is used for applying for an Enhanced Oil Recovery Well Permit in Louisiana.

This document is for applying for a permit to operate a saltwater disposal well in Louisiana.

This document provides the emergency plan for CCAP providers in Louisiana. It outlines the necessary steps and precautions to be taken during emergency situations.

This document provides a checklist of the required documents and information needed to apply for Child Care Assistance (CCAP) in the state of Louisiana.

This form is used for authorizing the release or obtaining of health information in Louisiana. It ensures compliance with HIPAA regulations for the protection of personal health information.

This form is used for applying for a Technician Registration Certificate in Louisiana.

This form is used for applying for a structural pest control license in Louisiana.

This document certifies someone as the Chief Executive Officer in the state of Louisiana. It verifies their position and authority within a company or organization.

This document is used for documenting the decisions and actions taken by the board of directors in the state of Louisiana.

This document outlines the bond requirement for contractors in Louisiana. It specifies the amount of bond that contractors must obtain to ensure their financial responsibility and compliance with state regulations.

This document is for individuals who are interested in applying to be a reviewer for the LDAF Specialty Crop Block Grant Review Panel in Louisiana.

This document is used to determine eligibility for the Louisiana 4 and Nsecd programs.

This document is used to request quarterly reimbursement from an employer for constables and justices of the peace in Louisiana.

This Form is used to request a Medicaid ID number for a newborn in the Medicaid Program in Louisiana.

This document updates the insurance information of Medicaid recipients in Louisiana.

This form is used for submitting institutional healthcare claims to Medicare Advantage plans in Louisiana.

This form is used for submitting professional crossover claims to Medicare Advantage plans in Louisiana.

This form is used for extending a physician outpatient visit in Louisiana through BHSF.

This form is used to refer pregnant individuals to the Medicaid program in Louisiana for dental services related to pregnancy.

This form is used for keeping a record of non-emergency medical transportation in Louisiana.

This document is for making a referral for extended foster care in Louisiana.

This Form is used for requesting adoption information in Louisiana under Article 1270 F of the Louisiana Civil Code.

This document is designed for the assessment of personal care needs according to the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) service in Louisiana. It gathers critical information about an individual's social circumstances, physical health, and personal care requirements.

This document is used for conducting a survey of FQHC (Federally Qualified Health Center) services facilities in Louisiana.

This form is used for requesting Medicaid EPSDT Personal Care Services in Louisiana.

This document is used for placing a physician's order for Personal Directed Health Care (PDHC) in the state of Louisiana.