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DSHS Form 27-122 Hcs / Aaa / Dda Individual Provider Contractor Intake - Washington (Portuguese)
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Portuguese. 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 Individual Provider Contractors in Washington.
Q: Who needs to fill out DSHS Form 27-122?
A: Individual Provider Contractors in Washington need to fill out this form.
Q: What does Hcs / Aaa / Dda stand for?
A: Hcs stands for Home and Community Services, Aaa stands for Area Agency on Aging, and Dda stands for Developmental Disabilities Administration.
Q: What is the purpose of the DSHS Form 27-122?
A: The purpose of this form is to gather information from Individual Provider Contractors in order to become enrolled with DSHS.
Q: Is this form specifically for Portuguese speakers?
A: No, this form is available in Portuguese, but it can be filled out by anyone.
Form Details:
- Released on April 1, 2018;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
Download a printable version of DSHS Form 27-122 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
Download DSHS Form 27-122 Hcs / Aaa / Dda Individual Provider Contractor Intake - Washington (Portuguese)
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