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OPWDD Form 159 (6 12 2024)

OPWDD Form 159 (6 12 2024)-2025

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The document provides detailed instructions for completing the OPWDD Form 159, which is a request for a Statewide Central Register Database Check. It outlines the necessary information required from registered providers and applicants, including personal details, household member information, and address history for the past 28 years. The form must be filled out electronically, signed by both the applicant and an authorized person from the agency, and submitted via email. Incomplete forms will be returned for corrections.

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