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Bcia 8016 form instructions

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The document provides detailed instructions for completing the DHS 8016 form, which is required to accompany the CMS 1500 claim form for documenting immunizations, screenings, and referrals during EPSDT visits in Hawaii. It outlines the necessary sections to fill out based on services provided, including patient information, immunizations given, screenings conducted (vision, audiometry, developmental, autism), referrals made, and a provider statement. The document emphasizes the importance of accurate documentation and adherence to recommended guidelines for child health assessments.

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What is contributing agency information?

Contributing Agency Information: Agency Authorized to Receive Criminal Record Information.

What is an 8016 form?

Bring a Request for Live Scan Service (DMV 8016) (PDF). There is also a $32 DOJ criminal record check fee that is collected at the live scan fingerprint site.

How do I check the status of my DOJ Live Scan?

Visit the California Department of Justice (DOJ) Applicant Background Check Status page. You will need your ATI number (Automated Transaction Identifier) and your date of birth to check the status. The status will indicate whether your Live Scan results are still pending or have been completed.

What does pob mean on Live Scan form?

If the fingerprints captured were unclear or of poor quality, the submission may be rejected. Data Entry Errors: If there were mistakes made when entering your information during the Live Scan process, this can also lead to rejection.

How to fill out a request for Live Scan service?

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