Representative Designation Forms, Arkansas

File Downloads / Links

Screening Form <a href="/sites/default/files/hcbs/files/166/8273/ICRepScreeningQuestionnaire.doc" target="_blank">Word</a>
Screening Form <a href="/sites/default/files/hcbs/files/166/8274/ScreeningForm.pdf" target="_blank">PDF</a>
Designation Form <a href="/sites/default/files/hcbs/files/166/8275/ICRepresentativeDesignation.doc" target="_blank">Word</a>
Designation Form <a href="/sites/default/files/hcbs/files/166/8276/ICRepresentativeDesignation.pdf" target="_blank">PDF</a>

Representative Designation Forms, Arkansas

Wed, 09/04/2013 - 00:04
Article Publication Date
Summary
Forms are provided for designating a representative and screening a representative for Arkansas' IndependentChoices program.
Topics
Consumer/Participant Direction
Types/Tools
Policy alerts, briefs, letters & papers
Template / Form
Populations
Personal Assistant
Sources
Other
Grantee produced
Arkansas
Programs/Initiatives
Cash and Counseling
Real Choice Systems Change
States
All States/Territories
Arkansas
Keywords
State/Agency Information
IndependentChoices Program; Cash Expenditure Plan; IndependentChoices monthly allowance; Designation for Authorized Representative Form; Representative Screening Questionnaire; participant's representative; A representative must; A representative cannot

Contact

Elizabeth
Maguire
National Resource Center for Participant-Directed Services
NULL
elizabeth.maguire.1@bc.edu
Phone
617-552-0562