DSS: Miscellaneous Documents
CT.GOV
Connecticut Department of Social Services
/dss Website
{Connecticut Department of Social Services}
 

Programs and Services for:
Families with Children
Elders
People with Disabilities
People with HIV/AIDS
Other Adults
Regional Offices
Informational:
Vendors / Contractors
News Media
Freedom of Information Requests
Publications
{ }

Governor Care and Share

Department of Social Services
25 Sigourney Street
Hartford, CT  06106-5033
 

{e-Alerts}
Receive DSS news updates by e-mail.
Subscribe now or update your e-Alerts

{Login}

Miscellaneous Documents


 
Miscellaneous
 

  Connecticut Home Care program For Elders Electronic Referral Form (120KB Word)

  Department of Social Services Electronic Health Screen (141KB Word)

  Mandated Reporter Form for Long Term Care Facilities (13KB)

{Internet Icon}   Elderly Services Division Publications 

  TANF State Plan 2006-2008 (369KB) (pdf format)

  The Report of the Teen Pregnancy Prevention Task Force (47KB) 
[MS Word 6.0 format] Problems downloading: call 1-800-842-1508

Out of State TANF Information Contacts 

  Selected Annual Federal Poverty and State Median Income Guidelines

  W-300 Medical Report (For Medicaid disability and SAGA cash benefits).

  W-300A Medical Statement

  W-303 Client Supplement for Medical Information (Version en Espanol)

  W-303A Permission to Share Medical Information

  W-374 Tennant Inspection  (Version en Espanol)


Fact Sheets

  Digital Imaging Fact Sheet (55KB)

  ConnPACE-Medicare FAQ

 

 


Content Last Modified on 11/18/2009 8:14:31 AM





Home | CT.gov Home |Send Feedback

State of Connecticut Disclaimer and Privacy Policy  Copyright © 2002 - 2009 State of Connecticut