
Get the free Missouri Part C Application 2017 - Missouri Department of ... - dese mo
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OMB NO. 18200550
Expires: 9/30/2017ANNUAL STATE APPLICATION UNDER PART C OF THE
INDIVIDUALS WITH DISABILITIES EDUCATION ACT AS AMENDED IN 2004
FEDERAL FISCAL YEAR (FLY) 2017CFDA No. 84.181AED FORM
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How to fill out missouri part c application

How to fill out missouri part c application
01
Obtain the Missouri Part C application form from the Missouri Department of Health and Senior Services or download it from their official website.
02
Read the instructions carefully before starting to fill out the application.
03
Provide your personal information accurately, including your full name, address, contact number, and date of birth.
04
Fill out the section regarding your insurance coverage, including information about your current health insurance policy or Medicaid eligibility.
05
Complete the section about your child's information, including their name, date of birth, and any medical conditions or disabilities.
06
Provide detailed information about the services you are seeking for your child, including therapy, early intervention programs, or other support.
07
Include any additional documents or attachments required, such as medical reports or supporting documentation.
08
Review the completed application form for any errors or missing information.
09
Sign and date the application form.
10
Submit the completed application form to the designated address mentioned in the instructions or as directed by the Missouri Department of Health and Senior Services.
11
Keep a copy of the completed application form and any supporting documents for your records.
Who needs missouri part c application?
01
Parents or legal guardians of children with developmental delays or disabilities who require early intervention services in Missouri need to fill out the Missouri Part C application form.
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What is missouri part c application?
Missouri Part C application is a form used to apply for services for infants and toddlers with developmental delays or disabilities in the state of Missouri.
Who is required to file missouri part c application?
Parents or caregivers of infants and toddlers with developmental delays or disabilities are required to file Missouri Part C application.
How to fill out missouri part c application?
Missouri Part C application can be filled out online or in person by providing information about the child's development and any concerns or delays.
What is the purpose of missouri part c application?
The purpose of Missouri Part C application is to determine eligibility for early intervention services for infants and toddlers with developmental delays or disabilities.
What information must be reported on missouri part c application?
Information such as the child's name, date of birth, developmental concerns, medical history, and contact information must be reported on Missouri Part C application.
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