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Child Care Forms - Department of Human Services
WEBDepartment of Human Services. Program Resources & Information. For Providers. Child Welfare for Providers. Child Care Forms. All forms are available in PDF format. Can't find the form you're looking for or need addtional information? Please contact the Regional …
WEBALLERGIES (INCLUDING MEDICATION REACTIONS) MEDICAL OR DIETARY INFORMATION NECESSARY IN AN EMERGENCY SITUATION MEDICATION, …
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WEBEMERGENCY MEDICAL CONDITION INFORMATION ELIGIBILITY FORM. Certain non-citizens may be eligible to receive Medical Assistance (MA) to cover medical expenses …
WEBHEALTH INSURANCE COVERAGE FOR CHILD or MEDICAL ASSISTANCE BENEFITS. POLICY NUMBER (REQUIRED) PARENT'S SIGNATURE IS REQUIRED FOR EACH …
WEBHealth Insurance Coverage or Medical Assistance Benefits. Policy Number (Required) PARENT'S SIGNATURE IS REQUIRED FOR EACH ITEM BELOW TO INDICATE …
WEBEMERGENCY CONTACT / PARENTAL CONSENT FORM. 55 PA CODE CHAPTERS §3270.124(a)(b), §3270.181 & §3270.182: §3280.124(a)(b), §3280.181 & §3280.182: …
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55 Pa. Code § 3290.124. Emergency contact information.
WEBEmergency contact information must reference who shall be contacted in an emergency. (b) Emergency contact information must include the following: (1) The name and birth …
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EMERGENCY-B&W.pub
WEBHEALTH INSURANCE COVERAGE FOR CHILD or MEDICAL ASSISTANCE BENEFITS. POLICY NUMBER (REQUIRED) PARENTS SIGNATURE IS REQUIRED FOR EACH …
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CHILD’S NAME
WEBNAME OF CHILD’S PHYSICIAN/MEDICAL CARE PROVIDER. TELEPHONE NUMBER-. ADDRESS. SPECIAL DISABILITIES (IF ANY) NOT REQUIRED FOR ENROLLMENT. …
WEBMar 2, 2021 · SIGNATURE OF PARENT/GUARDIAN DATE **If additional space is needed for emergency contacts or people to be released please just flip form over
55 Pa. Code § 3270.124. Emergency contact information.
WEBEmergency contact information must reference who shall be contacted in an emergency. (b) Emergency contact information must include the following: (1) The name and birth …
WEBEMERGENCY CONTACT/ PARENTAL CONSENT FORM 55 PA CODE CHAPTERS 3270.124(a)(b), 3270.181 & 182; 3280.124(a)(b), 3280.181 & 182; 3290.124 (a)(b), …
Apply for Benefits | Department of Human Services - PA.GOV
WEBOnline. Use the COMPASS website. You can see if you qualify, apply for, or renew benefits at the click of a button. Apply Online Using COMPASS. Have questions? View the …
Emergency Contact List - Ready PA
WEBYour emergency contact list will help you keep in contact with your family in case you are separated during a disaster. Complete an emergency contact card (PDF) for each …
C-22-04: Updated Emergency Preparedness and ... - THE …
WEBMar 11, 2024 · As such, changes have been made to Department of Human Services (DHS) Pennsylvania Statewide Child Care Emergency Plan. The plan identifies and …
Form CY867 Emergency Contact / Parental Consent Form
WEBDownload Printable Form Cy867 In Pdf - The Latest Version Applicable For 2024. Fill Out The Emergency Contact/parental Consent Form - Pennsylvania Online And Print It Out …
55 Pa. Code Chapter 3270. Child Care Centers - Pennsylvania …
WEBThe operator shall complete and update the form and provide a copy to the family in accordance with the updates regarding emergency contact information in § 3270.124 (f) …
WEBIf someone wants help getting a SSN, call 1-800-772-1213 or visit www.ssa.gov. TTY users should call 1-800-325-0778. Note: If you are a non-citizen applying for Emergency …
WEBEmergency Contact Info: (1) Name_______________________________________ Relationship___________________________. Address …
Helpful Phone Numbers | Department of Human Services - PA.GOV
WEBService. Phone Number. DHS HelpLine. 1-800-692-7462 (1-800-451-5886 TDD. for individuals with hearing impairments) Autism Services. 1-866-539-7689.
Governor Shapiro declares disaster emergency for Central PA …
WEBGovernor Shapiro has declared a disaster emergency for 21 counties, majority of which are in Central PA. The declaration comes as a response to the severe storms and flooding …
County Assistance Offices (CAO) | Department of Human …
WEBOFFICE HOURS: 8 a.m.-5 p.m. Toll-Free: 800-991-0929. Phone: 717-771-1100. LIHEAP: 1-800-991-0929. FAX: 717-771-1261. <p>Pennsylvania offers assistance and other …
Medicaid | Department of Human Services | Commonwealth of …
WEBApply for Medicaid. Renew Your Medicaid. HealthChoices is the name of Pennsylvania's managed care programs for Medicaid / Medical Assistance recipients. Through …
Governor Shapiro Signs Proclamation of Disaster Emergency For …
WEBAug 9, 2024 · “To expedite resources and cut through the red tape, I issued a disaster declaration in response to the severe storms and flooding all across Pennsylvania, …
WEBTELEPHONE NUMBER WHEN CHILD IS IN CARE TELEPHONE NUMBER ALLERGIES (INCLUDING MEDICATION REACTIONS) MEDICAL OR DIETARY INFORMATION …
Department of Human Services - PA.GOV
WEBUnder age 18 and a Pennsylvania resident; Lawfully present and provide or apply for a Social Security Number; and Disabled according to Social Security Administration (SSA) …
Regional OMHSAS Contacts | Department of Human Services
WEBAgencies Department of Human Services Contact Regional OMHSAS Contacts Regional Mental Health/Substance Abuse Field Offices Central Field Office: 717-705-8395 717 …
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