Forms List
Links to forms used in this course are found below and on pages throughout the course at the time a form is referenced. Although you are not required to print these forms, you will need them available as you take the course. You may choose to gather the forms from your county forms supply, or print them from eDocs using the following links.
DHS-3203 Medical Assistance Lien Worksheet (PDF).
DHS-3271 MHCP Request for Information (PDF).
DHS-5426 Long-Term Care Partnership and Medical Assistance Asset Protection (PDF).
DHS-5426A Permission to Share Long-Term Care Insurance Information (PDF).
DHS-5426C Long-Term Care Partnership Protected Assets (PDF).
DHS-5426D Long-Term Care Partnership Protected Assets Review (PDF).
DHS-5426E Long-Term Care Partnership Updated Insurance Information (PDF).
Page 3
Introduction