NY OPWDD Form 159 2024-2025 free printable template
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OPWDD Form 159 (6/12/2024)Instructions for Completing the
OPWDD Form 159
OPWDD Registered Provider Request for
Statewide Central Register Database Check Form
ALL information must be entered using
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How to fill out NY OPWDD Form 159
How to fill out NY OPWDD Form 159
01
Download NY OPWDD Form 159 from the official website.
02
Read the instructions carefully before filling out the form.
03
Fill in the personal information section with accurate details, including your name, address, and contact information.
04
Provide information about the individual for whom the form is being completed, including their date of birth and Medicaid number.
05
Complete the service information section, indicating the specific services needed.
06
If applicable, provide additional documentation or information as required.
07
Review the form for any errors or omissions before submission.
08
Submit the completed form as directed in the instructions.
Who needs NY OPWDD Form 159?
01
Individuals seeking services from the New York State Office for People With Developmental Disabilities (OPWDD).
02
Families or caregivers of individuals with developmental disabilities.
03
Advocates or service providers assisting in the application process.
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What is NY OPWDD Form 159?
NY OPWDD Form 159 is a form used by the New York State Office for People With Developmental Disabilities (OPWDD) to report specific information about individuals receiving services.
Who is required to file NY OPWDD Form 159?
Service providers and agencies that offer services to individuals with developmental disabilities in New York are required to file NY OPWDD Form 159.
How to fill out NY OPWDD Form 159?
To fill out NY OPWDD Form 159, one must provide accurate information in each section regarding the individual's personal details, service information, and any additional required reporting information.
What is the purpose of NY OPWDD Form 159?
The purpose of NY OPWDD Form 159 is to document and track the services provided to individuals with developmental disabilities, ensuring compliance with state regulations.
What information must be reported on NY OPWDD Form 159?
NY OPWDD Form 159 requires reporting information such as the individual's name, identifying details, the services they receive, and any pertinent updates or changes in their service status.
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