This version of the form is not currently in use and is provided for reference only. Download this version of Form HCA20-0061 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 HCA20-0061?
A: Form HCA20-0061 is the Sebb Certification of a Child With a Disability form in Washington.
Q: What is the purpose of Form HCA20-0061?
A: The purpose of Form HCA20-0061 is to certify a child as having a disability for the School Employees Benefits Board (SEBB) program in Washington.
Q: Who needs to complete Form HCA20-0061?
A: Form HCA20-0061 needs to be completed by parents or legal guardians of a child with a disability who are applying for benefits under the SEBB program in Washington.
Q: What information is required on Form HCA20-0061?
A: Form HCA20-0061 requires information about the child's disability, including the diagnosis, treatment, and limitations it presents, as well as information about the child's educational setting and any special education services received.
Q: Are there any deadlines for submitting Form HCA20-0061?
A: Yes, the form must be submitted within 60 days of the child becoming eligible for SEBB benefits or within 60 days of a qualifying event.
Form Details:
Download a fillable version of Form HCA20-0061 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.