About
Enrollment
Locations and Service Area
Agency Owners
Policies and Notices
FAQs
Leadership
Careers
Service Announcements
News
Events
Resources
Knowledge Center
For Providers
Newsletter Archive
Webinars
Getting Involved
Know Your Rights
Medicaid Renewal
Contact
About
Enrollment
Locations and Service Area
Agency Owners
Policies and Notices
FAQs
Leadership
Careers
Service Announcements
News
Events
Resources
Knowledge Center
For Providers
Newsletter Archive
Webinars
Getting Involved
Know Your Rights
Medicaid Renewal
Contact
SPANISH LANGUAGE FORM VERSIONS
:
Intake Cover Letter - Spanish
East Region Referral Form - Spanish
HIPAA Notice of Privacy Practices - Spanish
Acknowledgement of Notices and Privacy Practices - Spanish
Authorization for Release of PHI - Spanish
Blank Authorization for Release of PHI (For Additional Providers) - Spanish