DSHS Form 27-122 Hcs / Aaa / Dda Individual Provider Contractor Intake - Washington

What Is DSHS Form 27-122?

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 27-122?
A: DSHS Form 27-122 is an Intake form for HCS/AAA/DDA Individual Provider Contractor in Washington.

Q: Who is required to complete DSHS Form 27-122?
A: Individual Provider Contractors for HCS/AAA/DDA in Washington are required to complete this form.

Q: What is the purpose of DSHS Form 27-122?
A: The purpose of this form is to gather information about the individual contractor to determine their eligibility and qualifications for providing services.

Q: Are there any fees associated with submitting DSHS Form 27-122?
A: No, there are no fees associated with submitting this form.

Q: What happens after submitting DSHS Form 27-122?
A: After submitting the form, it will be reviewed by the DSHS to determine the eligibility and qualifications of the individual contractor.

Q: Are there any eligibility requirements to become an Individual Provider Contractor in Washington?
A: Yes, there are eligibility requirements that the individual contractor must meet. These requirements are outlined in the form.

Q: Can the DSHS deny an application based on the information provided in DSHS Form 27-122?
A: Yes, the DSHS has the authority to deny an application if the individual contractor does not meet the eligibility and qualification requirements.

Q: Is DSHS Form 27-122 specific to Washington state?
A: Yes, this form is specific to Washington state and is used by the Department of Social and Health Services.

Q: Is there a deadline for submitting DSHS Form 27-122?
A: There is no specific deadline mentioned for submitting this form, but it is recommended to submit it as soon as possible to avoid any delays in the approval process.