IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM …
IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM PROVIDER ENROLLMENT FORM CONTINUE READING THE INFORMATION BELOW CAREFULLY . BEFORE ... • Complete all items in PART A, answer the questions in PART B, and read and sign the declaration in PART C. • The county will: 1) Review the form to make sure it is complete; 2) Make photocopies
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