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STATE OF NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES THERAPEUTIC CANNABIS PROGRAM 129 PLEASANT STREET, CONCORD, NH 033013857 6032719333 18008523345 Ext. 9333 TDD Access: 18007352964 email:

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How to fill out caregiverattestation-rev11-1-16docx - dhhs nh

01

Open the caregiverattestation-rev11-1-16docx - dhhs nh document.

02

Read each section carefully to understand the information required.

03

Start by filling out the personal information section, including your name, address, and contact details.

04

Move on to the caregiver details section, where you will provide information about your relationship to the person you are caregiving for.

05

Fill in the necessary medical information about the person receiving care, including their condition and any medications they may be taking.

06

Provide any additional information requested in the document, such as details about your caregiving experience or qualifications.

07

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Make a copy of the filled-out form for your records.

10

Submit the completed form as directed by the DHHS NH.

Who needs caregiverattestation-rev11-1-16docx - dhhs nh?

01

Individuals who are providing caregiver services in the state of New Hampshire may need to fill out the caregiverattestation-rev11-1-16docx - dhhs nh document.

02

This document is often required by the Department of Health and Human Services (DHHS) in order to verify and approve caregiver services.

03

If you are providing care for a loved one or someone in need of assistance, you may be required to fill out this caregiver attestation form.

04

It is important to check with your local DHHS office or the relevant authority to determine if you need to complete this form.

05

The caregiverattestation-rev11-1-16docx - dhhs nh document helps DHHS identify and validate caregivers, ensuring that proper support and services are provided to those in need.

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