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Services My Government OF THE DISTRICT OF COLUMBIA DEPT OF HEALTH CARE FINANCE LONGER CARE ADMINISTRATIONPARTICIPANT CONSENT Nonparticipant Name: Authorized Representative (if applicable): I hereby
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01
Fill out the participant's personal information such as name, age, gender, and contact details.
02
Specify the services required by the participant, including the frequency and duration of service needed.
03
Indicate any specific preferences or requirements the participant may have regarding the services.
04
Provide any additional information that may be relevant to the participant's participation in the program.
05
Submit the completed form to the relevant service provider for processing and approval.

Who needs services my way participant?

01
Individuals who require personal care assistance and support services
02
People with disabilities who need specialized services and support
03
Elderly individuals who require assistance with daily living activities
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Individuals with chronic illnesses or mental health conditions in need of support services
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Services My Way Participant is a program that offers personalized support services for individuals with disabilities to help them live independently and participate in their communities.
Individuals with disabilities who are seeking support services to live independently and participate in their communities are required to file Services My Way Participant.
To fill out Services My Way Participant, individuals can contact their local disability services agency or visit the official website for instructions and application forms.
The purpose of Services My Way Participant is to provide personalized support services to individuals with disabilities, enabling them to live independently and engage in their communities.
Information that must be reported on Services My Way Participant includes personal details, disability status, support service needs, goals for independence, and preferences for services.
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