Cdac iowa 2026

1. Click ‘Get Form’ to open the CDAC Daily Service Record in the editor.
2. Begin by entering your name in the 'Provider name' field, including your first name, middle initial, and last name.
3. If applicable, input the agency name in the 'Agency name' section.
4. Fill in the 'Daily date of service' with the month, day, and year when you provided services.
5. Enter the consumer's full name in the 'Consumer name' field.
6. Input the consumer’s Medicaid ID number accurately.
7. Specify the location(s) where services were rendered.
8. Record your start and end times for each shift using am/pm format.
9. Select and enter the appropriate service code from the provided list that corresponds to your services.
10. Detail the actual hours of CDAC services you provided in the designated field.
11. Describe the specific services performed for the consumer in box 10.
12. Document any responses or changes observed from the consumer regarding those services.
13. Calculate and enter total hours worked for all approved CDAC services on this form.
14. Sign as the provider of service and enter today's date to finalize your record.

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