This version of the form is not currently in use and is provided for reference only. Download this version of Form HCA50-0142 for the current year.
This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form HCA50-0142?
A: Form HCA50-0142 is the Pebb Certification of a Child With a Disability form used in Washington.
Q: What is PEBB Certification?
A: PEBB Certification refers to the process of certifying that a child has a disability in order to qualify for certain benefits.
Q: Who needs to fill out this form?
A: This form needs to be filled out by a parent or guardian of a child with a disability who is applying for benefits.
Q: What benefits does this form qualify a child for?
A: This form is used to determine eligibility for certain benefits, such as healthcare coverage and special education services.
Q: Is there a deadline for submitting this form?
A: There may be specific deadlines for submitting this form, so it is recommended to check with the relevant agencies or programs for more information.
Q: What documents are required to accompany this form?
A: Documentation of the child's disability may be required, such as medical records or an evaluation from a qualified professional.
Form Details:
Download a fillable version of Form HCA50-0142 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.