Adult BH HCBS End User Training for New Customers - Assessment Form - Signatures

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For additional information on the form click on form help.

• All signature sections must be completed to lock this form.
• Upon signing, the form will validate the patient has available units remaining in Patient Details > Service Thresholds tab.
• This service will be available for processing in My Billing once it is saved with Direct Service Staff.
  • The Recipient Signature not required for processing.