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DCS COMMUNITY BASED PROVIDER REQUEST TO EXPAND SERVICES This form should be used for providers with an already existing DCS contract to add counties/regions from a service standard already included
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How to fill out dcs-community-based-provider-request-to- template

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How to fill out dcs-community-based-provider-request-to

01
Begin by entering the basic information of the community based provider such as name, address, contact information, etc.
02
Specify the type of services that the community based provider offers and the target population they serve.
03
Include any relevant certifications or licenses that the provider holds.
04
Describe the specific needs or requests that the provider has from the Department of Children's Services.
05
Attach any supporting documents or references that may be helpful for the request.

Who needs dcs-community-based-provider-request-to?

01
Community based providers who offer services to children and families in need may need to fill out the DCS community-based provider request form.

What is DCS-COMMUNITY-BASED-PROVIDER-REQUEST-TO- ... Form?

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DCS community-based provider request form is used to request services from community-based providers for children and families involved with the Department of Child Services.
Case managers and social workers working with the Department of Child Services are required to file the dcs-community-based-provider-request-to form.
The form should be completed with all necessary information about the child or family in need of services, as well as the type of services requested and the provider being recommended.
The purpose of the form is to facilitate the request for services from community-based providers to support children and families in need.
Information such as the child's name, age, case number, the type of services needed, provider information, and the reason for the request must be reported on the dcs-community-based-provider-request-to form.
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