IA DHS 470-0643 2016-2025 free printable template

Iowa Department of Human Services Request for Child and Dependent Adult Abuse Information Persons or agencies with authorized access to child or dependent adult abuse information must use this form

How to fill out child dependent abuse form

How to fill out IA DHS 470-0643

1. Obtain the IA DHS 470-0643 form from the Iowa Department of Human Services website or local office.
2. Fill out your personal information at the top of the form, including your name, address, and contact details.
3. Complete the sections related to your household information, including names and relationships of household members.
4. Provide details about your income, including sources and amounts, for all household members.
5. Indicate any other relevant information requested on the form, such as assets or expenses.
6. Review the form for accuracy and completeness.
7. Sign and date the form at the designated section.
8. Submit the completed form to your local DHS office or through the specified submission method.

Who needs IA DHS 470-0643?

1. Individuals or families seeking assistance with food programs, medical support, or other social services in Iowa.
2. Those who are applying for or reapplying for benefits through the Iowa Department of Human Services.

People Also Ask about

What is Iowa Department of Human Services Bureau of Collections?

“BOC” means Bureau of Collections, a bureau of the Department of Human Services responsible for the establishment and enforcement of child support.

What does Iowa Department of Human Services do?

Iowa HHS provides high quality programs and services that protect and improve the health and resiliency of individuals, families, and communities.

How do I become a mandatory reporter in Iowa?

Mandatory Reporter Training 2 hours initial training. 1 hour renewal training every 3 years if the date on the training certificate has not expired. If training has expired, 2 hour training will be required.

What is mandatory reporting state of Iowa?

The oral report shall be made by telephone or otherwise to the Department of Human Services (1-800-362-2178). If the person making the report has reason to believe that immediate protection for the child is advisable, that person shall also make an oral report to an appropriate law enforcement agency.

Who oversees the Department of Human Services in Iowa?

Praised for transformative leadership, Kelly Kennedy Garcia serves as the Director of the Iowa Department of Human Services (DHS). Governor Kim Reynolds appointed Garcia to oversee the state's health and social services agency in November 2019.

How long does Iowa mandatory reporter training last?

Is my mandatory reporter training still valid? Check the completion date. Training completed before July 1, 2019, is valid for five years, and training completed on or after July 1, 2019, is valid for three years.

What is the Iowa Department Human Services Integrated Claims Recovery?

The Integrated Claims Recovery Unit is a small unit of 12 IMW2 positions that support program integrity and provide ongoing cost savings and cost avoidance through eliminating duplicate assistance and establishing overpayment claims for Medicaid, Food Assistance and FIP.

What is Iowa Department of Human Services responsible for?

The agency provides human services, including healthcare services, assistance services, food programs, and disaster relief. The department also allows residents of Iowa to report incidents of fraud or abuse. The department also manages juvenile justice facilities and training schools in the state.

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What is IA DHS 470-0643?

IA DHS 470-0643 is a form used by the Iowa Department of Human Services for various reporting and documentation purposes related to social services.

Who is required to file IA DHS 470-0643?

Individuals or organizations involved in providing services that require reporting to the Iowa Department of Human Services may be required to file IA DHS 470-0643.

How to fill out IA DHS 470-0643?

To fill out IA DHS 470-0643, one must provide accurate information as required by the form, follow the provided instructions, and ensure all relevant sections are completed.

What is the purpose of IA DHS 470-0643?

The purpose of IA DHS 470-0643 is to collect necessary information for the administration of social services and ensure compliance with state regulations.

What information must be reported on IA DHS 470-0643?

IA DHS 470-0643 requires reporting details such as the name of the service provider, services rendered, client information, and any relevant state-required data.