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Form M-27r - NYC HRA Nurse's Assessment Visit Report (8/07/02)
Nurses Assessment Visit report used in NYC.PDF
This copy of the form was completed by NYC HRA for an in-service training conducted by HRA for nurses that do these assessments. Thus this is a model form. Also see the HRA Instructions for the form.
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18 May, 2009
365 kb
Downloads: 12220
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Consumer Directed Assistance Program Offers Greater Autonomy to Recipients of Home Care
CDPAP NYSBA article.pdf
Article published in NYS Bar Association Journal, January 2003, written by Valerie J. Bogart, Esq.
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18 May, 2009
67 kb
Downloads: 14179
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Westchester County Medical Recommendation for Personal Care Services - Form # 1050
1050-Westchester Physicians Order.doc
This is the form that a doctor should complete to request Medicaid personal care services from the Westchester County DSS. Revised November 2007.
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15 May, 2009
90 kb
Downloads: 9557
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Q-Tips - Tips for completing the M-11q Form - Español
Q-tips_Esp.pdf
This memo by Selfhelp gives tips for successfully completing the Form M-11q to request personal care services in NYC. This version was translated into Spanish by the Legal Aid Society.
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20 Mar, 2009
64 kb
Downloads: 14044
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Continuation Page for Form M-11q
M-11q Continuation.dot
This template for Microsoft Word lets you easily accommodate comments that are too long to fit in the space provided on the M-11q form.
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20 Mar, 2009
25 kb
Downloads: 7419
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Homecare Reimbursement Worksheet
Reimbursement Worksheet.xlt
This Excel template was created by Selfhelp to duplicate the worksheet used by the NYC Homecare Reimbursement Unit. Having it in Excel makes it easier to complete, but it prints out to look exactly like the one distributed by the City.
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19 Feb, 2009
21 kb
Downloads: 11249
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Home Care Reimbursement Form
Reimbursement Form.pdf
This form is used by the NYC Homecare Reimbursement unit
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19 Feb, 2009
11 kb
Downloads: 16262
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