IHSS Health Care Certification Form (SOC 873.pdf)

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(IHSS) Program Health Care Certification Form

This health care certification form must be completed and returned to the. IHSS worker listed ... The information provided in this form will be ... SOC 873 (10/16).

New Medical Certification Requirement - Fact Sheet

Aug 18, 2011 - IHSS Medical Certification. 2. The SOC 873 form also asks for other information. 2. Who are Licensed Health Care Professionals? A licensed ...

application packet in-home supportive services (ihss)

Enclosed is a blank copy the Medical Certification Form (SOC873) that you can give to your Licensed Health Care Provider (LHCP) to complete. The county can ...

in-home supportive services

Jan 1, 2015 - ty o f Sacram en to. Dep artm en. t o f Health. &. H u m an. Serv ices. P. O B o x. 2. 6. 9. 1. 3 ... To apply for IHSS call (916) 874-9471 ... complete a Health. Care Certification

In-Home Support Services (IHSS)

Cal Personal Care Services Program (PCS), the IHSS Independence Plus ... .org/factsheets/medi-cal_fs/PDFs/FS_Community-Based-Medi-Cal-Programs.pdf. .... to have your health care provider fill out a medical

In-Home Supportive Services (IHSS) Program

The IHSS Program will help pay for services provided to you so that you can stay safely in ... You must submit a completed Health Care Certification form. ... A completed Health Care Certification (SOC


audit of the In-Home Supportive Services (IHSS) Program audit .... 2 SOC 873: IHSS Health Care Certification Form (State Health and Human Services Agency).

Transgender Health Services Surgery Aftercare Referrals

Sheemddress AM Zip Phone ls Spouse an IHSS Reclplent. Y N. Ethnicity; Languages: ls ... without the health care certification form SOC 873 ***. *lt yes, why are ...

IHSS Health Care Certification form (SOC 873.pdf)

In-home supportive services (ihss) program health care certification form note: the ihss worker may contact you for additional information or to.

sc ihss newsletter 9 21 11

called SOC873 (this is in addition to the form that the ... out and signed by a licensed health care professional ... -home care if without the assistance of IHSS.

Last Updated: 28th February 2021


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