These files are related to IHSS Health Care Certification form (SOC 873.). Just preview or download the desired file.
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).
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 ...
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 ...
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
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
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).
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 ...
In-home supportive services (ihss) program health care certification form note: the ihss worker may contact you for additional information or to.