Soc873 2026

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  1. Click ‘Get Form’ to open the soc873 in the editor.
  2. Begin by filling out Section A, which includes your name, date of birth, address, IHSS case number, county of residence, and contact details for your IHSS worker.
  3. In Section B, authorize the release of your health care information by printing your name and signing the form. If applicable, a witness must also sign.
  4. Section C is for a licensed health care professional. They will need to answer questions regarding your ability to perform daily living activities and whether IHSS services are recommended.
  5. Ensure that all required fields in Section C are completed accurately. The health care professional should provide detailed descriptions of your condition and the services they provide.
  6. Finally, in Section D, the licensed health care professional must certify their information by signing and providing their license details before submitting the form back to the IHSS worker.

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Versions Form popularity Fillable & printable
2016 4.8 Satisfied (62 Votes)
2011 3.8 Satisfied (30 Votes)
2011 4.3 Satisfied (48 Votes)
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