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How to use or fill out dhcs 5050 2013 form with our platform
- Click ‘Get Form’ to open the dhcs 5050 2013 form in the editor.
- Begin by entering the Facility Name and Provider Number at the top of the form. Ensure that you designate volunteers by placing a 'V' next to their names.
- In the Counselor Information section, fill out each staff member's details, including their title, scheduled hours per week, and whether they are certified, registered, or licensed. Remember that at least 30% of counseling staff must be licensed or certified.
- For each employee listed, provide additional information such as Date Hired, Last TB Test Date, and First Aid/CPR training dates. This ensures compliance with facility requirements.
- Complete the Effective and Expiration Dates for Licensure, Certification, or Registration for each staff member. Include certification numbers and organizations as required.
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