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Home and Community Based Services (HCBS) Provider Quality SelfAssessment2023Instructions This form is required for organizations enrolled to provide HCBS Waiver or Habilitation services in section
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The 470-4547 form is used to report and assess eligibility for home and community-based services and supports.
Individuals seeking home and community-based services, their representatives, or guardians are required to file the 470-4547 form.
To fill out the 470-4547 form, complete all required sections, provide necessary documentation, and ensure clarity and accuracy in reporting information regarding services needed.
The purpose of the 470-4547 form is to gather comprehensive information to determine eligibility for various home and community-based services.
The form requires details such as personal information, service needs, medical history, and financial status.
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