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DISABILITYSTATEMENTFORINHOMESUPPORTIVESERVICES California Victim Compensation Program Cal VCP Application No.: When no other reimbursement source is available the Cal VCP may reimburse a victim/claimant
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Begin by providing your personal details in the designated fields. This may include your name, address, contact information, and any other relevant identifiers.
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If applicable, provide information about your disability or the disability of the individual for whom you are filling out the form. Include relevant medical documentation if required.
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Proceed to complete any sections related to in-home supportive services. This may include details about the type of assistance needed, the frequency of services required, and any other relevant information.
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It is a form used to provide a disability statement for in-home supportive services.
Individuals receiving in-home supportive services may be required to file this form.
The form should be completed with accurate information regarding the individual's disability and support needs.
The purpose of the form is to document the individual's disability status for in-home supportive services.
The form may require detailed information about the individual's disability, medical history, and support requirements.
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2013 California vcgcb CalVCP 60-day claimant DISABILITYSTATEMENTFORIN aspx recertification TobeCompletedbytheTr requestor VCGCB-VCP-12 pra seq 5th oag DRS-19250 DSFIHSS VCGCBs infovcgcb InfoSecurityandPrivacyvcgcb recertify exigent reimbursement edicts el

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