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This version of the form is not currently in use and is provided for reference only. Download this version of
Form FA-24C
for the current year.
Form FA-24C Authorization Request for Self-directed Skilled Services - Nevada
What Is Form FA-24C?
This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. Check the official instructions before completing and submitting the form.
FAQ
Q: What is Form FA-24C?
A: Form FA-24C is an Authorization Request for Self-directed Skilled Services in Nevada.
Q: What is the purpose of Form FA-24C?
A: The purpose of Form FA-24C is to request authorization for self-directed skilled services in Nevada.
Q: Who can use Form FA-24C?
A: Form FA-24C can be used by individuals who want to request authorization for self-directed skilled services in Nevada.
Q: Is there a fee for submitting Form FA-24C?
A: No, there is no fee for submitting Form FA-24C.
Q: What information do I need to provide on Form FA-24C?
A: You will need to provide personal information, medical history, and details about the skilled services you are requesting on Form FA-24C.
Form Details:
- Released on September 28, 2015;
- The latest edition provided by the Nevada Department of Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form FA-24C by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
Download Form FA-24C Authorization Request for Self-directed Skilled Services - Nevada
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