DSHS Form 10-673 Request for Icf / Iid or Nf Services at an Rhc Admission Application - Washington

What Is DSHS Form 10-673?

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 10-673?
A: DSHS Form 10-673 is a form used to request ICF/IID or NF services at an RHC admission application in Washington.

Q: What does ICF/IID stand for?
A: ICF/IID stands for Intermediate Care Facility for Individuals with Intellectual Disabilities.

Q: What does NF stand for?
A: NF stands for Nursing Facility.

Q: What is an RHC?
A: RHC stands for Rural Health Clinic.

Q: What services can be requested on DSHS Form 10-673?
A: ICF/IID or NF services can be requested on DSHS Form 10-673.

Q: Who can use DSHS Form 10-673?
A: Anyone applying for ICF/IID or NF services at an RHC in Washington can use DSHS Form 10-673.

Q: Are there any fees associated with submitting DSHS Form 10-673?
A: There are no fees associated with submitting DSHS Form 10-673.

Q: What supporting documents are required with DSHS Form 10-673?
A: The required supporting documents may vary, but generally include proof of residency, income, and disability.

Q: What is the purpose of DSHS Form 10-673?
A: The purpose of DSHS Form 10-673 is to request ICF/IID or NF services at an RHC admission application in Washington.