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Forms

HHS forms are used every day to perform tasks such as applying for benefits, contracting to provide goods or services, reporting incidents, declaring end of life wishes, and conducting other business.

ES = Spanish version available.

Title
Form 3926, Change of Disability
Form 3916, Sponsor Report
Form 3915, Certificate of Attendance
Form 3914, Continuing Education Unit (CEU) Attendance Sign-in Sheet
Form 3913, Request for Approval of Proposed Training for General and Court Interpreters Continuing Education Units (CEUs)
Form 3152, Equipment Inventory List
Form 3151, Personnel Activity Report
Form 3112, Cancer Disability Medical Report
Form 3105, Hearing Evaluation Report
Form 3103, Cardiac Evaluation Report
Form 3102, Pulmonary Evaluation Report
Form 3101, Consultant Review
Form 2896, Consumer Services Report: O&M Training
Form 2879, Service Provider's Travel Log
Form 2868, Assistive Technology Training Report
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