Connecticut State Department of Social Services Forms
The Connecticut State Department of Social Services (DSS) is responsible for providing a range of social services and assistance programs to residents of Connecticut. Its main purpose is to help individuals and families in need access healthcare coverage, nutrition assistance, financial support, and other supportive services. DSS programs include Medicaid, Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and childcare assistance, among others. The department's primary goal is to promote self-sufficiency, improve the well-being of individuals and families, and ensure that basic needs are met.
Documents:
36
This Form is used for conducting a checklist for new employee orientation in the state of Connecticut.
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This Form is used for authorizing the use of long-acting sustained release opioids under the Connecticut Medical Assistance Program.
This form is used for supplementing medical information for clients in Connecticut. It helps gather additional details related to their medical condition.
This document is for individuals or organizations applying for a Certificate of Need in the state of Connecticut. It includes all the necessary forms and instructions for the application process.
This Form is used for requesting exemption for acquired brain injury (LCA) in Connecticut.
This document is a Spanish version of the W-303S Customer Supplement for Medical Information form, specifically for residents of Connecticut. It is used to gather additional medical information from customers.
This form is used for applying for the determination of spousal assets in the state of Connecticut. It helps in assessing the assets owned by spouses and their financial situation for various purposes.
This Form is used for the Renewal of Eligibility for residents of Connecticut. It is required for individuals to maintain their eligibility for certain state programs.
This document is used for applying for long-term care or waiver in the state of Connecticut.
This document is a Form W-1 LTCS used to apply for Long Term Care Services and Exemption in Connecticut.
This Form is used for applying for Title IV-D Child Support Enforcement Services in Connecticut.
This form is used for requesting a waiver for acquired brain injury (ABI) in Connecticut. It is specifically designed for individuals who have suffered from ABI and need assistance.
This document is used for submitting a medical report to fulfill the work requirements for ABAWD (Able-Bodied Adults Without Dependents) in Connecticut.
This form is used for requesting a referral for a Personal Care Attendant (PCA) in Connecticut. It is used to initiate the process of finding a PCA to provide personal care services to individuals in need.
This form is used for applying for payment of funeral and burial expenses in the state of Connecticut.
This Form is used for requesting replacement of food purchased with SNAP benefits in Connecticut.
This form is used for reporting the admission or discharge of residents in rated housing facilities or residential care homes in Connecticut.
This Form is used for requesting a referral for a Personal Care Assistant (PCA) in Connecticut.
This document is used for setting up direct deposit for vendors in Connecticut.
This form is used for requesting Medicaid prescription vouchers or authorizations for payment in the state of Connecticut.
This document is used by Community Options to refer individuals to services and programs in Connecticut. It helps connect people with the necessary support they need.
This type of document is a Spanish version of Form W-298S, used in Connecticut. It is an Authorization to Disclose Information form.
This form is used for authorizing the disclosure of information in the state of Connecticut.
This form is used for applying for Title IV-D child support enforcement services in Connecticut.
This document is used for reporting patient referrals between agencies in Connecticut.
This form is used for authorizing direct deposit of funds in the state of Connecticut.
This document is used for authorizing direct deposit of payments in Connecticut.
