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State of Hawaii Department of Human Services Request Division DHS/Request Division Medical Standards Branch P. O. Box 700190 Cupola, HI 967090190REQUEST FOR PRIOR AUTHORIZATION OUTOFSTATE MEDICAL

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What is dhs 1144c -0104doc?

dhs 1144c -0104doc is a form used for reporting certain information to the Department of Homeland Security.

Who is required to file dhs 1144c -0104doc?

Certain individuals or entities designated by the Department of Homeland Security are required to file dhs 1144c -0104doc.

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dhs 1144c -0104doc can be filled out electronically or manually following the instructions provided by the Department of Homeland Security.

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The purpose of dhs 1144c -0104doc is to collect specific information required by the Department of Homeland Security for regulatory or informational purposes.

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The specific information to be reported on dhs 1144c -0104doc will be outlined in the instructions provided by the Department of Homeland Security.

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