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Home and Community Based Services (HCBS) Provider Quality SelfAssessment 2022Instructions This form is required for organizations enrolled to provide HCBS Waiver or Habilitation services in section
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01
Obtain the application form from the Lee County DHS SouthHealth website or local office.
02
Fill in your personal information including your name, address, and contact details.
03
Provide information regarding your household members and their income details.
04
Specify the services you are applying for, such as food assistance, health care, or rental assistance.
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Review the completed application for accuracy and completeness.
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Submit the application either online, by mail, or in person at the Lee County DHS SouthHealth office.
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Follow up with the office for confirmation of receipt and any further steps needed.

Who needs lee county dhs southhealth?

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Individuals or families in need of financial assistance.
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Low-income residents seeking health services or food support.
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People experiencing housing instability.
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Those requiring medical benefits or therapy services.
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Lee County DHS SouthHealth is a division of the Department of Human Services in Lee County that focuses on providing health services, support, and resources to the community.
Individuals who are applying for assistance programs or seeking health services through the Lee County DHS SouthHealth are typically required to file.
To fill out the Lee County DHS SouthHealth application, individuals need to gather necessary documentation, complete the application form accurately, and submit it according to the guidelines provided by the agency.
The purpose of Lee County DHS SouthHealth is to offer health services, promote public health, provide access to healthcare resources, and assist individuals in need of social services.
The information that must be reported typically includes personal identification details, income sources, household information, and any medical needs or assistance required.
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