Ihss New Provider Form. Web complete, sign and return the ihss program provider enrollment form (soc 426) directly to the county ihss office or ihss public authority. Do not send the form to cdss.
Fill out, sign and return this form in person to the office or location designated by the county. Web complete, sign and return the ihss program provider enrollment form (soc 426) directly to the county ihss office or ihss public authority. Over 550,000 ihss providers currently serve over 650,000 recipients. Armenian | chinese | spanish Web these requirements include completing, signing, and returning (in person) the provider enrollment form (soc 426), submitting fingerprints and being cleared of disqualifying crimes through a criminal background check, completing a provider orientation, and returning a signed provider enrollment agreement (soc 846). Web go on to the next page provider enrollment form instructions: For additional guidance, contact your county ihss office or ihss public authority. Do not send the form to cdss. Web if you want to become an ihss provider, you must complete all the steps outlined in the document linked below before you can be enrolled as a provider and receive payment from the ihss program for providing services. Use black or blue ink to fill out.
Do not send the form to cdss. This health order does not apply to a provider who: The paper enrollment form is available on the cdss website for those who want to use it. Lives with the recipient (s), or. Web these requirements include completing, signing, and returning (in person) the provider enrollment form (soc 426), submitting fingerprints and being cleared of disqualifying crimes through a criminal background check, completing a provider orientation, and returning a signed provider enrollment agreement (soc 846). Web the paper enrollment form is available on the cdss website for those who want to use it. Armenian | chinese | spanish Do not send the form to cdss. Web if you want to become an ihss provider, you must complete all the steps outlined in the document linked below before you can be enrolled as a provider and receive payment from the ihss program for providing services. Web complete, sign and return the ihss program provider enrollment form (soc 426) directly to the county ihss office or ihss public authority. Over 550,000 ihss providers currently serve over 650,000 recipients.
