Only required for providers live in HCSIS within the VG portal.
This information is provided by the Department of Developmental Services.
- Dictionary (PDF)
- Form (PDF)
- Form Instructions (PDF)
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Frequently Asked Questions (RTF)
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Quick Guide (RTF)
Download the printer-friendly PDF to print and complete as a hard-copy.
Or use the Rich-Text Format (RTF) to download onto your computer and complete electronically.
This information is provided by the Department of Developmental Services.
