Oregon dhs home care worker: free download. On-line document store on 5y1.org

[PDF File]REPORT OF ACTUAL OR SUSPECTED CHILD ABUSE OR …
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DHS Facility – Refers to any group home, shelter home, halfway house or institution operated by the Department of Human Services. DCH Facility – Refers to any institution or facility operated by the Department of Community Health. 15.-19 - Reporting person’s name - Enter the name and address of person(s) reporting this matter.
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[PDF File]Form W-9 (Rev. October 2018)
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• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.
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[PDF File]INSTRUCTIONS : UNUSUAL INCIDENT/INJURY
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community care licensing division unusual incident/injury report instructions : notify licensing agency, placement agency and responsible persons, if any, by next working day. submit written report within 7 days of occurrence. retain copy of report in client’s file. name of facility facility file number city, state, zip
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[PDF File]Power of Attorney for Health Care
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questions about the availability of the Power of Attorney for Health Care form or obtaining larger quantities of the form, you may contact the Division of Public Health by telephoning 608-266-1251. Definitions ‘Department’ means the Department of Health Services. ‘Health Care’ means any care, treatment, service, or
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[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,
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[PDF File]Consent for Release of Information
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If you want us to release a minor child's medical records, do not use this form. Instead, contact your local Social Security office. I am the individual, to whom the requested information or record applies, or the parent or legal guardian of a minor, or the
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[PDF File]2018 Schedule SE (Form 1040)
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Schedule SE (Form 1040) 2018. Attachment Sequence No. 17. Page . 2 . Name of person with. self-employment. income (as shown on Form 1040 or Form 1040NR) Social security number of person
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[PDF File]Request for Leave or Approved Absence
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Request for Leave or Approved Absence. 1. Name (Last, first, middle) 2. Employee or Social Security Number (Enter only the last 4 digits of the Social Security Number (SSN))
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[PDF File]Application for Social Security Card
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Application for a Social Security Card. ... have DHS work authorization, you must prove that you have a valid non-work reason for requesting a card. See page 2 for an explanation of acceptable documents. NOTE: If you are age 12 or older and have never received a Social Security number, you must apply in ...
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[DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal
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The Aid Codes Master Chart was developed for use in conjunction with the Medi-Cal Automated Eligibility Verification System (AEVS). Providers must submit …
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Oregon dhs home care worker