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TRAUMATIC BRAIN INJURY WAIVER Personal Attendant WorksheetMembers First and Last Name: ___ Personal Attendants(PA) Name: ___Begin Date: ___ End Date: ___Month:Reflect Month and Day of the Weekday:
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To fill out the hcpfcoloradogovbrain-injury-waiver-bibrain injury waiver bicolorado, follow these steps:
02
Download the form from the HCPF Colorado website.
03
Read the instructions and guidelines carefully to understand the eligibility criteria and required documentation.
04
Provide personal information such as name, address, contact details, and social security number.
05
Fill in the necessary medical information related to the brain injury, including the diagnosis, treatment, and medical history.
06
Include any supporting documentation from healthcare professionals or specialists.
07
Complete the financial information section, including income and asset details.
08
Sign and date the form to certify the accuracy of the provided information.
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The hcpfcoloradogovbrain-injury-waiver-bibrain injury waiver bicolorado is designed for individuals who meet the eligibility criteria for the Brain Injury waiver program in Colorado. This waiver provides services and supports to individuals with brain injuries, including traumatic brain injury or acquired brain injury, who require assistance with their daily living activities, rehabilitation, and community integration. Eligibility is based on specific criteria related to the individual's brain injury diagnosis, functional limitations, income, and residency in Colorado.
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The Brain Injury Waiver (BI) is a Medicaid home and community-based services (HCBS) waiver that provides services to individuals with a brain injury.
Individuals with a brain injury who meet the eligibility criteria for the waiver are required to file the Brain Injury Waiver.
To fill out the Brain Injury Waiver, individuals need to submit an application with the required documentation and meet with a case manager for an assessment.
The purpose of the Brain Injury Waiver is to provide services and supports to individuals with a brain injury to help them live in the community.
Individuals must report personal information, medical history, functional limitations, and the services needed to support their independence.
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