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Click ‘Get Form’ to open the 470 3372 form in the editor.
Begin by entering the consumer's name and the CDAC provider's name in the designated fields. Ensure that all names are spelled correctly for accurate documentation.
In the 'Agreement' section, both parties must review and agree to the terms outlined. This includes understanding responsibilities and payment rates.
Complete the 'Responsibility' section by detailing emergency plans, evaluating the CDAC provider’s training, and describing how services will be managed and evaluated.
Fill out the 'Standards for the CDAC provider' section, confirming age, skills, and insurance details as required. Make sure to provide clear answers.
Document service activities by specifying time requirements and frequency for each activity listed. Use 'Not applicable' where necessary.
Review all entries for accuracy before signing. Both consumer and CDAC provider must sign to validate the agreement.
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How do i get a 470 3372 form pdfHow do i get a 470 3372 form onlineHow do i get a 470 3372 form hcbsHow do i get a 470 3372 form 2022Form 470 4389HCBS Elderly and Disabled Waiver
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