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Indiana state form 48896 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the name of your facility at the top of the form. Select whether your facility is for profit or non-profit.
- Fill in the contact details, including telephone number, name/title of the contact person, address, FAX number, and email address.
- Provide information about your Alzheimer's/Dementia Special Care Program/Unit, including total number of beds and Medicaid certified beds.
- Answer questions regarding mission/philosophy statements and admission processes. Ensure you provide clear responses in the designated spaces.
- Complete sections on staffing patterns and training requirements by specifying staff ratios and types of training provided.
- Review all entries for accuracy before saving your completed form. Once satisfied, download or print directly from our platform for submission.
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| Versions | Form popularity | Fillable & printable |
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| 1998 | 4.9 Satisfied (380 Votes) |
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by M Volovski 2015 Cited by 15 Form DOT F 1700.7 (8-69). Page 4. EXECUTIVE SUMMARY. INDIANA STATE HIGHWAY COST. ALLOCATION AND REVENUE ATTRIBUTION. STUDY AND ESTIMATION OF TRAVEL BY. OUT-OFRead more
State Form 48896 (R2 / 2-24). Indiana Family and Social Services Administration, Division of Aging (per IC 12-10-5.5). Name of facility. Check one: For Profit.Read more