Form CERT-12 Service Declaration: Residential Habilitation Services Group-Home Habilitation Site Information / Change of Status Report - Alaska

Form CERT-12 Service Declaration: Residential Habilitation Services Group-Home Habilitation Site Information / Change of Status Report - Alaska

What Is Form CERT-12?

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

Form Details:

  • Released on February 14, 2020;
  • The latest edition provided by the Alaska Department of Health and Social 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 CERT-12 by clicking the link below or browse more documents and templates provided by the Alaska Department of Health and Social Services.

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Download Form CERT-12 Service Declaration: Residential Habilitation Services Group-Home Habilitation Site Information / Change of Status Report - Alaska

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  • Form CERT-12 Service Declaration: Residential Habilitation Services Group-Home Habilitation Site Information / Change of Status Report - Alaska, Page 1
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