Transcription of APPLICATION PACKET - Florida
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APPLICATION PACKET - Florida
APPLICATION PACKET CDC+ APPLICATION Instructions CDC+ APPLICATION Hiring and Working with Your Consultant Questions you can ask when interviewing a Consultant New Consultant Evaluation Form CDC+ Participant/Consultant Agreement Representative Agreement APPLICATION Instructions Revised 2015-12-10 CDC+ APPLICATION Instructions Please follow the instructions below in order to fill out the CDC+ APPLICATION . You will need to obtain a copy of your most current Support Plan and cost plan in order to fill out all sections of this form. Be sure to print all information in capital letters. Section I - PARTICIPANT 1. Fill in the participant s legal first name, last name, and middle initial. Do not enter a nickname or abbreviation. 2. Obtain the participant s (consumer s) Medicaid ID number. This 10 digit number may be found on your Support Plan or obtained from your Waiver Support Coordinator.
APPLICATION PACKET CDC+ Application Instructions CDC+ Application Hiring and Working with Your Consultant Questions you can ask when interviewing a Consultant
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