Dhhs maine.gov forms
WebMaine Office of Behavioral Health 207-287-2595 TTY: Maine Relay 711 Fax: 207-287-9152 41 Anthony Ave. #11 State House Station Augusta, ME 04333-0011 Driver Education and Evaluation Programs (DEEP) 207-626-8600 TTY: Maine Relay 711 Fax: 207-287-3903 Email: [email protected] Prescription Monitoring Program (PMP) 207-287-2595 … WebUpload Hearing Document Programs Down Arrow MaineCare/Cub Care SNAP (Food Assistance) TANF (Cash Assistance) Help & FAQ Sign In Languages Arabic (عربى) Afsomali (Afsoomaali) Chinese (中文) English (English) French (Français) Khmer (ភាសាខ្មែរ) Spanish (Español) Swahili (Kiswahili) Vietnamese (Tiếng Việt) Overview Benefits
Dhhs maine.gov forms
Did you know?
WebOTHER FORMS; NRC LICENSE GUIDANCE DOCUMENTS : Reciprocity Reports Form (HHE 865) Individual Advanced Addition (HHE 851) Rules Require Form (HHE 870) Medical Physicist training (HHE 853) Licensee List Request form (HHE 871) Industrial Radiography OJT supplement (HHE 854) Request is Disposition (HHE 892) Radiographer …
WebYou can get free help with your benefits application. Call an Office for Family Independence Representative. An OFI representative can: give you more information on benefits. … Web•Fill out both pages of the form completely, including signing the Confidentiality and Non-Disclosure statement on page 2 •The completed forms should be: •Faxedto Office of Vital Records, 207-287-2618 OR •Emailedto [email protected] •The form is reviewed, and if approved an email will be sent out with login information for DAVE
WebIf you run into problems with this new system - or delays in processing your online application - contact DHHS at: 1-855-797-4357 (HELP) (Monday through Friday 8:00 am to 5:00 pm), or [email protected] If DHHS does not resolve your problem, contact Maine Equal Justice Partners. Go to My Maine Connection now. August 2012 PTLA # 798 WebMy Maine Connection – Your online connection to Food Supplement, Health Care, Cash Assistance and/or Child Care; DHHS Office Addresses – Locate the DHHS … VISIT …
WebThe instructions for completing the form are also available (in Adobe PDF format). If you need to contact someone regarding Transfer Forms, call the Office of Aging and …
WebStep 4: File the court forms To file, you must mail or hand deliver signed originals with proof of service to the court with the required filing fee of $120. If you cannot afford to pay the filing fee, you may file an Application to Proceed without Fee … easy canvas prints shipping codehttp://mainecarepdl.org/pafiles easy canvas prints canadaWebA copy of this order can be found on the Judicial Branch website at www.courts.maine.gov, under Rules & Administrative Orders. Copies and fees: The fee for copies is $2 for the first page and $1 for each additional page. Attested copies (with the Court seal) require an additional fee of $5 per document. easy canvas prints free shipWebApr 10, 2024 · Listed below are all the PA forms you will need in order to request drugs that require prior authorization. MaineCare Preferred Drug List. To submit a request: Select … cup glass jars with locking lidsWebThis form allows the Maine Department of Health and Human Services to release your personal identifiable information to a consumer or another person they designate. ... easy canvas carbonless print+meansWebMaine DHHS is comprised of ten offices and divisions that deliver critical programs and services for Mainers. Not included below, the Commissioner’s office is seeking nearly $4 million for centralized shared services, such as Maine IT, and two positions. easy canvas pro appWebForms. Eligibility to Release Information (PDF) This form allows DHHS to release or obtain a participant's pharmaceutical, billing or other confidential records to or from another provider/agency. Authorized Representative (PDF) Into appoint an authorized representative to act on your for with DHHS. easy canvas prints + free shipping