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Commonwealth of Massachusetts REQUEST FOR ADULT SERVICES Department of Mental Health (DM) Effective October 2009 (Revised April 2011) Application for Adult Services Instructions The Department of
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How to fill out an application for continuing care:

01
Start by gathering all the necessary documents and information, such as personal identification, medical history, and financial records.
02
Carefully read through the application form to understand the requirements and instructions.
03
Fill out the personal information section accurately, providing your full name, address, contact details, and any other requested information.
04
Provide relevant medical information, including details about your current health condition, any medication you are taking, and any previous medical treatments or surgeries.
05
If applicable, include information about your insurance coverage or any other financial assistance you may be receiving for continuing care.
06
Answer any additional questions or sections on the application form that are specific to your situation or facility requirements.
07
Double-check all the information you have entered to ensure accuracy and completeness.
08
Submit the application form by the designated method, whether it is online, by mail or in person.

Who needs an application for continuing care?

01
Individuals who require long-term care or assistance with daily activities due to age, illness, disability, or other medical conditions.
02
Family members or legal guardians who are responsible for the care and well-being of someone in need of continuing care.
03
Healthcare professionals or social workers who are assisting individuals in finding suitable continuing care options.
Note: The specific requirements and process for applying for continuing care may vary depending on the country, region, or specific facility. Therefore, it is always recommended to consult with the relevant authorities or facility administrators for accurate and up-to-date information.
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An application for continuing care is a form that individuals are required to submit in order to request ongoing care and support services.
Anyone who is in need of ongoing care and support services is required to file an application for continuing care.
To fill out an application for continuing care, individuals must provide personal information, medical history, details about their current situation, and any specific care and support requirements.
The purpose of the application for continuing care is to assess and determine the eligibility of individuals for ongoing care and support services.
The application for continuing care requires individuals to report personal information, medical history, current situation, and specific care and support requirements.
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