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DHS6633Lead agency case manager may complete this checklist to determine eligibility for the exception. County: Participants Name: Date: Participants Date of Birth: Waiver Type: PMI#: CriteriaMeets

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To fill out DHS-6633 - Chisago County, follow these steps:

02

Download the DHS-6633 form from the Chisago County website or get a physical copy from the county office.

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Start by providing your personal information such as your name, address, and contact details.

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Indicate the purpose of your request and the specific information you are seeking.

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Submit the filled DHS-6633 form to the appropriate Chisago County office either in person or by mail.

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DHS-6633 - Chisago County is needed by individuals who require certain information or services provided by the Chisago County office. This form acts as a formal request to access specific information or services related to Chisago County programs, benefits, or resources. Anyone seeking such information or services may need to fill out DHS-6633.

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