ES = Spanish version available.

Form Title  
1581 Consumer Directed Services Option Overview ES
1582 Consumer Directed Services Responsibilities ES
1583 Employee Qualification Requirements ES
1584 Consumer Participation Choice ES
1585 Acknowledgement
of Responsibility for Exemption from Nursing Licensure for Certain
Services Delivered through Consumer Directed Services
ES
1586 Acknowledgement of Information Regarding Support Consultation Services in the Consumer Directed Services (CDS) Option ES
1587 Financial Management Services Agency (FMSA) First Consumer Fax Cover Sheet  
1720 Appointment of a Designated Representative ES
1721 Revocation of Appointment of Designated Representative ES
1722 Employer's Selection for Electronic Visit Verification Responsibilities  
1723 Electronic Visit Verification (EVV) Request for Employer Phone Number(s)  
1724 New Employee Packet Cover Sheet  
1725 Criminal Conviction History and Registry Checks  
1726 Relationship Definitions in Consumer Directed Services Employer's Acknowledgment and Certification  
1727 Occupational Exposure to Bloodborne Pathogens  
1728 Liability Acknowledgement  
1729 Applicant Verification for Employees  
1730 Wage and Benefits Plan Employee Compensation  
1731 Employee Work Schedule and Assigned Tasks  
1732 Management and Training of Service Provider  
1732-EMR Management and Training of Service Provider Addendum  
1733 Employer and Employee Acknowledgement of Exemption from Nursing Licensure for Certain Services Delivered through Consumer Directed Services  
1734 Service Provider and Employer Certification of Relationship Status for CDS  
1735 Employer and Financial Management Services Agency Service Agreement ES
1736 Documentation of Employer Orientation by Financial Management Services Agency  
1737 Employer and Employee Service Agreement ES
1739 Service Provider Agreement ES
1740 Service Backup Plan ES
1741 Corrective Action Plan ES
1745 Service Delivery Log with Written Narrative/Written Summary  
1747 Acknowledgement of Nursing Requirements  
1749 Employer and Entity Service Agreement ES
2067 Case Information  
2101 Authorization for Community Care Services  
2124 Supported Home Living/Community Support Transportation Log ES
3687 Provider Agency Findings of Fiscal Monitoring Review  
3853 Contract Evaluation Summary  
8400 Consumer-Directed Services (CDS) Support Advisor Applicant  
8584-CDS Comprehensive Nursing Assessment and Plan of Care - HCS Program ES