Alaska Temporary Assistance Program Forms and Office Locations – Government Agency in Alaska

121 - 140 of 227 forms

Form Title	Topics
Harmony Access Coordinator Agreement form
Harmony Privacy and Security Agreement (Individual Provider User)
Health and Safety Requirements for In-home Child Care
Health Status Report
IDD-01 Eligibility Determination and Request for Services Application
IDD-03 ICAP Assessment Information and Consent
IDD-04 Developmental Disabilities Registration and Review
IDD-06 Guidelines for ICAP Process
IDD-10 Interim ICF/IID Level of Care
IDD-11 ICF/IID Level of Care Determination
IDD-12 Guidelines for QDC Form
IDD-13 Qualifying Diagnosis Certification Form
IDD-14 Request for QDC
IDD-15 Request for Exception, Day Habilitation In-Residence
Individual Care Coordinator Conflict of Interest Assurance
In-home Child Care Application
In-home Child Care Application Coversheet
In-home Child Care Parent / Caregiver Agreement
In-home Child Care Renewal Application Coversheet
Instructions for Completing the COVID-19 Appendix K Person Centered Support Plan Request

1 contact point

Phone numbers:

Alaska Temporary Assistance Program