Florida Regulations 64F-19.003: Certification and Authorization
Current as of: 2024 | Check for updates
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(1) Waiver applicants shall give written consent before the CHD can obtain or authorize the release of financial and medical information for the purpose of determining Program eligibility. Eligibility information will be obtained by filling out form DOH 3212 as referenced in Fl. Admin. Code R. 64F-19.011
(2) Signed consent forms of eligibility for DOH 3212, as referenced in Fl. Admin. Code R. 64F-19.011, must be kept in an administrative file at the CHD that enrolled the client in the Program for a minimum of six (6) years.
Rulemaking Authority 154.011, 381.0011(13), 381.0051(7) FS. Law Implemented 154.011, 381.0051 FS. History-New 8-9-04, Amended 2-17-08.
(2) Signed consent forms of eligibility for DOH 3212, as referenced in Fl. Admin. Code R. 64F-19.011, must be kept in an administrative file at the CHD that enrolled the client in the Program for a minimum of six (6) years.
Rulemaking Authority 154.011, 381.0011(13), 381.0051(7) FS. Law Implemented 154.011, 381.0051 FS. History-New 8-9-04, Amended 2-17-08.