Please Complete and Notarize the Application (Application - DHHR - wvdhhr 2026

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Definition & Purpose of the DHHR Application

The "Please Complete and Notarize the Application (Application - DHHR - wvdhhr)" is a formal document primarily used within the realm of health and human resources in West Virginia. Its intent is to streamline the process by which applicants can provide required personal information and verify their credentials, such as proof of current state registration or specific professional qualifications. This application includes sections for notarization, ensuring that the submitted details are authenticated and legally binding. It is a vital step for individuals seeking reciprocity or certification within certain fields, such as health services.

Steps to Complete the DHHR Application

Completing this application involves a series of specific steps to guarantee both accuracy and compliance:

  1. Gather Necessary Information: Before filling out the application, ensure you have all required information, such as personal identification, proof of current state registration, and any relevant certifications or credentials.

  2. Fill Out Personal Details: Accurately enter all personal information in the designated sections. This typically includes your full name, address, contact details, and identification numbers.

  3. Attach Supporting Documents: Include any required supporting documents, such as proof of registration or certification. Each document should be clear and legible.

  4. Complete the Notarization Section: This part of the application requires an authorized notarization to verify the authenticity of the information provided. Schedule a visit with a notary public and bring a valid form of identification.

  5. Review and Finalize: Before submission, review the entire application to confirm that all information is correct and complete.

  6. Submit the Application: Depending on the instructions provided, submit the application either online, via mail, or in person.

Importance of Notarizing the DHHR Application

Notarization serves as an essential aspect of this application. It offers a level of trust and legal standing, ensuring that all information is correct and the document is free from fraud. Notarization also provides a verified acknowledgement that all details are presented truthfully, which is critical for acceptance by the Department of Health and Human Resources.

Who Uses the DHHR Application

Individuals who typically need to complete this application are those working within health and human services sectors. This may include registered sanitarians seeking to practice in West Virginia through reciprocity agreements, healthcare professionals applying for state certification, or individuals seeking to comply with state-specific registration requirements.

Key Components of the DHHR Application

The application consists of several critical sections necessary for its completion:

  • Personal Information Section: Gathers basic identification and contact details.

  • Credentials & Certifications Section: Requires documentation proving current state registration or qualifications.

  • Notarization Block: Must be filled out in the presence of a notary public to ensure the authenticity of provided details.

  • Checklist of Required Items: Offers a comprehensive list to verify all necessary components are included before submission.

State-Specific Requirements for West Virginia

In West Virginia, there might be unique prerequisites tied to this application. For instance, applicants may need to adhere to state-specific codes of ethics or specific deadlines peculiar to West Virginia's government processes. Additionally, residents or non-residents aiming for reciprocity must understand these state-specific nuances.

Examples of Utilizing the DHHR Application

  • Healthcare Professional Relocation: A registered nurse moving to West Virginia requires state recognition of their credentials—completing this form facilitates the legal practice within the new state.

  • Reciprocity for Registered Sanitarians: Professionals from other states looking to work in West Virginia must use this application to align with local regulations.

Legal Implications of the DHHR Application

The legal significance of this form cannot be understated. By completing and notarizing the application, the individual formally declares all provided information is accurate to the best of their knowledge, reducing potential legal liabilities against misinformation. Falsifying details could lead to severe penalties, highlighting the importance of accuracy and sincerity when completing the application.

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West Virginia DHHR LIHWAP Water Bill Pay Assistance Households whose utility payments are included in their rent may also be eligible for LIHWAP. LIHWAP provides one-time payments to low-income households that are eligible for assistance.
What is Customer Services? How do I report changes to Customer Services? By phone: 1-877-716-1212; e-mail: dhhrbcfchangectr@wv.gov; fax: 304-558-1869; and U.S. Postal Service: P.O. Box 1668, Charleston, WV 25326-1668.
Your Financial Institution will provide you with a record of deposits in your account. Also you may view your payment information online via the FACTS PLUS web application.
Report to DHHR Then, choose My Changes to report any changes to your info. By phone: Call 1-877-716-1212 to contact your DHHR caseworker. You can call Monday through Friday, 9 AM to 5 PM.

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