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01. Edit your disclosure of charges online
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How to use or fill out disclosure of charges with our platform
- Click ‘Get Form’ to open the Adult Family Home Disclosure of Charges in the editor.
- Begin by entering the home/provider’s name, date, and license number at the top of the form. This information is essential for identifying the specific adult family home.
- Review the Medicaid Information section carefully. Ensure you understand how Medicaid payments are accepted and any conditions that apply.
- Fill out the Admission Fees section if applicable. Clearly state any admission fees required by the home, including additional comments if necessary.
- Proceed to Deposits and Prepaid Charges sections. Specify amounts and purposes for each deposit or prepaid charge, ensuring full disclosure as required.
- Complete Other Fees/Charges by detailing any additional costs associated with services provided, such as transportation or personal care assistance.
- Finally, review all sections for accuracy before saving your completed form. Utilize our platform's features to easily share or print your document.
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