Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico

Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico

Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.

FAQ

Q: What is the Mi Via Self-directed Waiver?
A: The Mi Via Self-directed Waiver is a program in New Mexico that allows individuals with disabilities to have more control over their services and supports.

Q: What is the Service and Support Back-Up Plan Acknowledgement Form?
A: The Service and Support Back-Up Plan Acknowledgement Form is a document that individuals participating in the Mi Via Self-directed Waiver program in New Mexico must complete.

Q: What is the purpose of the Service and Support Back-Up Plan Acknowledgement Form?
A: The purpose of the Service and Support Back-Up Plan Acknowledgement Form is to ensure that individuals have a plan in place to address any gaps in services and supports in case of emergencies or other situations.

Q: Who needs to complete the Service and Support Back-Up Plan Acknowledgement Form?
A: Individuals who are participating in the Mi Via Self-directed Waiver program in New Mexico need to complete the Service and Support Back-Up Plan Acknowledgement Form.

Q: What happens if an individual does not complete the Service and Support Back-Up Plan Acknowledgement Form?
A: If an individual does not complete the Service and Support Back-Up Plan Acknowledgement Form, they may be ineligible for the Mi Via Self-directed Waiver program.

Q: Is the Service and Support Back-Up Plan Acknowledgement Form specific to New Mexico?
A: Yes, the Service and Support Back-Up Plan Acknowledgement Form is specific to the Mi Via Self-directed Waiver program in New Mexico.

ADVERTISEMENT

Form Details:

  • Released on March 1, 2018;
  • The latest edition currently provided by the New Mexico Department of Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Department of Health.

Download Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico

4.5 of 5 (47 votes)
  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico

    1

  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 2

    2

  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 3

    3

  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 4

    4

  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 5

    5

  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 1
  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 2
  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 3
  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 4
  • Mi via Self-directed Waiver: Service and Support Back-Up Plan Acknowledgement Form - New Mexico, Page 5
Prev 1 2 3 4 5 Next
ADVERTISEMENT