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Get the free Division of Services for People with Disabilities - Utah.gov

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MIKE FOGARTYBRAD KERCHIEF EXECUTIVE OFFICERGOVERNORSTATE OF OKLAHOMA HEALTH CARE AUTHORITYOHCA 200509June 15, 2005Dear Waiver Services Provider: The Department of Human Services, Developmental Disabilities
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Begin by providing your personal information including your name, address, and contact information.
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Clearly outline the services being provided or divided, including any specific details or terms of agreement.
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Specify the duration or timeframe for the services being divided.
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Both parties must sign and date the division of services document to acknowledge agreement and understanding.

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Individuals or businesses who are entering into a service agreement with another party may need to fill out a division of services form to outline the services being provided or divided.
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