Form ODM02392 Designation of Authorized Representative for Home Care Attendant Services - Ohio

Form ODM02392 Designation of Authorized Representative for Home Care Attendant Services - Ohio

What Is Form ODM02392?

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

FAQ

Q: What is ODM02392?
A: ODM02392 is a designation form for authorized representatives for home care attendant services in Ohio.

Q: What is an authorized representative?
A: An authorized representative is a person who is chosen by an individual to act on their behalf and make decisions related to their home care attendant services.

Q: Who needs to fill out ODM02392?
A: Individuals who receive home care attendant services in Ohio and want to designate someone as their authorized representative need to fill out ODM02392.

Q: What is the purpose of ODM02392?
A: The purpose of ODM02392 is to officially designate an authorized representative for home care attendant services in Ohio.

Q: Is ODM02392 mandatory?
A: No, filling out ODM02392 is not mandatory, but it is a way to ensure that someone can make decisions on your behalf regarding your home care attendant services.

Q: What information is required on ODM02392?
A: ODM02392 requires information about the individual receiving home care attendant services, as well as the information of the designated authorized representative.

Q: Can I change my authorized representative?
A: Yes, you can change your authorized representative by filling out a new ODM02392 form and submitting it to the appropriate authorities.

Q: How long is ODM02392 valid for?
A: ODM02392 is valid until it is revoked or a new form is submitted with updated information.

Q: Can I have multiple authorized representatives?
A: Yes, you can have multiple authorized representatives, but each one needs to be designated individually on a separate ODM02392 form.

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Form Details:

  • Released on November 1, 2015;
  • The latest edition provided by the Ohio Department of Medicaid;
  • 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 ODM02392 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.

Download Form ODM02392 Designation of Authorized Representative for Home Care Attendant Services - Ohio

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