Michigan department of health human services: free download. On-line document store on 5y1.org

[DOT File]Initial Relative Safety Screen - Michigan
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INITIAL RELATIVE SAFETY SCREEN Michigan Department of Health and Human Services Caseworker Name Caseworker Phone MDHHS County or PAFC Name Date of Home Visit Child(ren) Names DOB Legal Relationship to Prospective Caregiver Person ID DEMOGRAPHICS Caregiver(s) Name Maiden Name, Aliases, AKA (if applicable) DOB Date of Central Registry Request Date of …
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[DOC File]Request to Discharge State-Owed Debt
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Signature Print Name Date The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs or disability.
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[DOCX File]Request for Food Stamp Authorized ... - Michigan Legal Help
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The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs or disability.
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[DOCX File]HIPAA/DATA Incident Report - MI Health
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Michigan Department of Health and Human Services. Today’s Date. Date of Incident. Time of Incident (if applicable) Date Incident Discovered Contact Information. Your Name. MDHHS Division/Section Your Phone Number. Your Email Your Location
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[DOT File]DHS-1258, Employer Payment Coupon Remittance
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To contact the MiSDU with questions, call 800-817-0805 option 1, or email MiSDUOutreach@michigan.gov. Michigan Department of Health and Human Services (MDHHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or ...
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MDHHS - Michigan Department of Health and Human Services
The Michigan Department of Health and Human Services (MDHHS) - Michigan Department of Health and Human Services Browsers that can not handle javascript will not …
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[DOT File]Authorization to Release Confidential Information - Michigan
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The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs or disability.
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[DOC File]Support Collection Payment Request
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FOR CENTRAL OFFICE USE ONLY Michigan Department of Health and Human Services Request Refunds Separately by Collection Type. Do Not Make Entries in Shaded Areas PLEASE TYPE OR PRINT CLEARLY. 2. Load Number 3. Prog 4. County Number 5. Customer’s Name (Last, First, Middle) 6. MDHHS Case Number 7. Payment Amount 8.
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[DOT File]DHS-1377, Direct Deposit Authorization Form
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Michigan Department of Health and Human Services (MDHHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability.
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[DOC File]MICHIGAN DEPARTMENT OF COMMUNITY HEALTH
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DEPARTMENT OF HEALTH AND HUMAN SERVICES. MANAGED CARE PLAN DIVISION. PLAN MANAGEMENT SECTION. P.O. Box 30479. Lansing, MI 48909. Heather Slawinski, Section Manager. Janna Compau, Section Secretary. Revised 5/10/2017. Contract Manager Comprehensive Health Care Plans Dental Plans Darryl Bragg . 517-284-1164. braggd@michigan.gov Aetna Better ...
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Michigan department of health human services