This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form F-62369?
A: Form F-62369 is a waiver for hospice or home health services by a terminally ill resident of a Community Based Residential Facility (CBRF) in Wisconsin.
Q: Who can use Form F-62369?
A: This form can be used by terminally ill residents of CBRFs in Wisconsin who wish to waive hospice or home health services.
Q: What is a Community Based Residential Facility (CBRF)?
A: A Community Based Residential Facility (CBRF) is a residential facility in Wisconsin that provides care and services to individuals, typically the elderly, who need some assistance with daily activities.
Q: What does this form waiver?
A: This form waives the hospice or home health services that would typically be provided to a terminally ill resident of a CBRF.
Q: Why would someone want to waive hospice or home health services?
A: Someone may want to waive hospice or home health services if they have alternate arrangements for care or if they prefer not to receive these services.
Form Details:
Download a printable version of Form F-62369 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.