%PDF-1.5 <> 7/2OPcMTvsoDZ)jYJle^VzYdJ]UyU:U%W_U.JQubFMPs0. %PDF-1.6 % The following tips can help you fill out NH DHHS DFA 756 quickly and easily: Open the document in the feature-rich online editing tool by clicking Get form. These services are intended to enhance communication, cooperation, productivity, and teamwork in the workplace. NH Department of Health and Human Services (DHHS) DFA Form 720 Division of Family Assistance (DFA) 02/13 rev 1/15 DFA SR 13-04 (5YC) DETERMINATION OF INCAPACITY STATUS Name: Return Completed Form to: Centralized Scanning Unit (CSU) Case Number: P.O. NH Department of Health & Human Services (DHHS) DFA Form 65 Division of Family Assistance (DFA) 11/01 Rev 3/2011 rev2 3/15 DFA SR 01-36 (3YC) Client's Printed Name Date Client's Case Number CLIENT STATEMENT Shelter Statement Fraud Statement Voluntarily Withdrawing Application Voluntarily Terminating However, in some cases, the State requires of all individuals the obligation to report certain facts which come to their attention. In our free Buyers Guide to Document Management, the other types of scanning can be found. The EAP provides a number of unique services. Centralized Intake Bureau Chief, Laura McCullough (406) 444-6849: Centralized Intake Specialist Supervisor, Vacant (406) 444-3286: Centralized Intake Specialist Supervisor, Rachel Rolston (406) 444-9846 Tel: +1 201 455 0150. During calcium scoring, the amount of calcium in the coronary arteries is measured and a score is obtained that can help determine an individual's risk for heart attack or heart disease. stream Register and get access to reusable templates today! x}o7?$s{Cd--644zh=)4EUz?>^/.=^>ybyu?~8_|^vWfW_}V8{OO_9/r+|fO\.B\Wo9N>>'_ But for now, here are the differences between centralized scanning and decentralized scanning. Also, looking into a maintenance agreement on the scanner can ensure that your scanner will run at . NH Department of Health and Human Services (DHHS) DFA Form 756 Division of Family Assistance (DFA) 07/07 Rev 8/15 Thank you for your cooperation. (3YC) Employment Verification (Completed by Employer Only) FROM: Centralized Scanning Unit (CSU) P.O. 1 0 obj 2023 State of New Hampshire All rights reserved, An official NEW HAMPSHIRE government website, www.covid19.nh.gov/resources/treatment-resources, Communication Access & Language Assistance, Alcohol, Tobacco & Other Substance Misuse, Resources for DHHS Providers, Small Business & Nonprofits, Search for programs in the main contact directory. Need Help Applying? rU}BZyM+]\; ea7PT-@3Dg,.f+63j g$E!`B When calcified plaques occur in the coronary arteries, the condition is called coronary artery disease, or CAD, which is a leading cause of heart attack and death. Our free Buyers Guide to Document Management contains more information on scanning, along with other important facts to know about creating a document management system for your business. Suicide Prevention: 988. %PDF-1.5 }U-Zwjy'5k7P|X,*!4"\+4s]TE,+;h].jEznQ-jv-]7M=tT 4)/G&FdD%+ RWpb]3 If you test positive for COVID-19 and have symptoms, antiviral medication can help! Calcium scoring is primarily used for people with specific risk factors for heart attack and heart disease who are considered to have an intermediate risk for having a heart attack in the next decade that is, about a 10 percent to 20 percent chance or slightly more. % 2 0 obj 3 0 obj Go to the Locations & Facilities page. Economic Assistance: (800) 383-4278. Box 181, Concord, NH 03301 DFA SR 11-43 (A) REIMBURSEMENT AGREEMENT AND ACKNOWLEDGMENT Applicant Name: Spouse: Name: (Please print) (Please print) . 3 0 obj %PDF-1.5 Specialist within DHHS, via DHHS's Centralized Scanning Unit, PO Box 181, Concord, NH 03301. The following procedures are performed by our Interventional Radiology team at designated hospitals. However, DHHS will not share your health information. The EAP liberally defines family member to include significant people in the lives of employees. 2 0 obj Have a Question About Your Assistance? Trying to find an office? 36T_9?=)^wU(Z^ V[$&Bb5F$|zt ==c a41j01P F!+dPP;)\1iU2hSB_On)/JTa1"BL$CJG ZSv ,M0_9*mmMHd6uCm+jE":E@HVQP(U * jr-pKVI$HV $$Qm%H+&58O^AS,As*F%$U)jDJ":% *%mJZ%:5mJnc(O2 1 0 obj 5m!$N@or:F&x'ni/@Fs3[4 7g ~K_x 0|O^}Epq|B?~A(Ty`++E IR lxQ=w%`:P5@TuE7AF[u$&^kf$it&+Il0*g\K$_0TqtHO3 E~z^e_JB;(G$TVQ*Y AdTmpd3h2HU2$`Y| 4 ~0(-D7p;Ib4(+GB)J}*C:2!q7j6QSk0` RNa*UvfqGNyEj]\DsYZEQ e#z`rV3Fm&kwbq~Yu?;.Q5w]' UQ mjQ?w41K,_ddyuHMLl" x Q>ou30*}$hO)([e\/dDxV[e(-xRAxcmv%,Bi_lE3/BU"Uh2qM myqT/<9b>yv Y- up3q9O)` 1 0 obj Concord, NH 03301 2023 State of New Hampshire All rights reserved, An official NEW HAMPSHIRE government website, www.covid19.nh.gov/resources/treatment-resources, Communication Access & Language Assistance, Alcohol, Tobacco & Other Substance Misuse, Resources for DHHS Providers, Small Business & Nonprofits, Identify issues before they disrupt your personal or professional life, Improve an employee's ability to carry out his/her job, Any form of neglect or abuse to children or the elderly, Posing a threat of harm to self or others. When calcified plaques occur in the coronary arteries, the condition is called coronary artery disease, or CAD, which is a leading cause of heart attack and death. For information on available treatment in NH, go to www.covid19.nh.gov/resources/treatment-resources. hb```UB2B eadh ^cPjixHQu%-\J1``h``` R0,* d`.EX, I-$?oLMKs73c!F00_yl Vl9 @WM7-1.O]d)wXn{Bap\Z-6`7]q){ biB3~K:3l2/a_P{q 4 0 obj <>>> q^.I7khxGF:F@u~V(l^yZVo h|-('- <> <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> It is best that you check with your individual insurance plan before scheduling the exam. }.oWn~zvX,yzqQeiY'RS$*Ks#A=}s4$Tc Medicaid Assistance: (855) 632-7633. more.. iServe Nebraska . Once the exam begins, you'll lie flat on the CT exam table and sticky electrodes will be adhered to your chest. DFA SR 07-05 (3YC) Employment Verification (Completed by Employer Only) FROM: Centralized Scanning Unit (CSU) P.O. Google Earth Plug-in ONLY operates on Microsoft Windows . 1193 0 obj <>/Filter/FlateDecode/ID[<8C2304EE3BAA2B4BA51333F619C6E237><6A45965FEF636F41A7C4DDF41080F3DD>]/Index[1170 38]/Info 1169 0 R/Length 111/Prev 271610/Root 1171 0 R/Size 1208/Type/XRef/W[1 3 1]>>stream When should you upgrade your printer or copier? DHHS has a wide range of programs located in offices across the state. [j T*[oD? | gZ&)wI,H&-`~YbZ'G~ o+XwH Y_\Ljs. hbbd```b``6@$2,^qA$k*X6L`Y00V/ "OkAd>-`@D% E Abuse & Neglect: (800) 652-1999. (o}Wy]vCf \^ <> x]mo7 aiQ"&mmR,&A[#_hH{v#Ky'gtd]|]n? \@ 9x i~u #~Q5L76qs%b~:j{Q-AtwLE[sX af Q|cRKQdFej!$o"s~Jcv-RCCHny6$LC3`fac$?mnM;? Calcium scoring is a diagnostic imaging system that uses CT (computed tomography) scans of the coronary arteries to detect the presence of calcified plaque, a substance that builds up inside the artery walls and hardens, making it difficult for oxygen-rich blood to reach the heart. 2 0 obj <>>> stream YuLlvLMLyZW*T&2`?! :.e,"[fNkL+az ;m;^]TD+6*jUT u**Z@ EAP services are confidential and voluntary to assist NH government employees and their families in addressing issues that may affect their overall well-being. NH Department of Health and Human Services (DHHS) BFA Form 474 Bureau of Family Assistance (BFA) 10/19 Return this form to: Centralized Scanning Unit (CSU), P.O. Calcium scoring is a fast and painless method of determining a person's risk for heart attack and heart disease. endobj This buildup of calcified plaque in artery walls is called atherosclerosis, or "hardening" of the arteries. <> <>>> Q\z15b>='w23\K|&6`.lo]2VdITi2-'\NOJL6'o3?nZ. endobj 4]irpmP@;BM'Yp8eV9. NH Department of Health and Human Services (DHHS) BFA Form 775 Bureau of Family Assistance (BFA) 09/22 RENTAL VERIFICATION REQUEST (To be completed by the landlord or Housing Authority, if subsidized.) nRqIP,lK?2|/!.Qf]Sya^>Pec{$h-0e18nr:DQE8O`]fd. x TF3e>,YecW=f~+J}VQiIvCYA~,IE`z1Fb2aw(G#&Jv-4m6n} `|UzT4MPjJ5"3t* 0'Kf(:0W;i~EcqcFH g|d&@EO;H65$D_$@F\7v*$ ISb\}]lXHPPm?.W;Ez'"NC6[B$!"/}Ys+DiW(xjnc[k;-:4!C[S .^8\xqn\ -3vGnJ` &8~"Hz`Qg:Z[9I(di_oHlWtd8C1XqRwl!goNrpB+o@IkCA/9OM=Uu%PW\-RPyV`eJe z1~_9AQwet]*clH"[^gD2 LXmVgXRAk]U:=QOO|yjwGSg{e`)*44'-lSTiTG!H1RJVe$3/o"kE@SOkK@eq;IMYF1D&|z@cDBUsgaf{1*Q'e=4kTh#1\T,UR5ni+pmz; Uy~*6\=[Q{6aLXjBGpBsVB};Zn\Rt/$_jDw ]1VZgv*8ukN0|[J:C$aX/+B`%1vKQT 7DWg[X4018l_pEfH(y%|}$OW+GN6>k=gsh{VR8o_Q?]%8.\5]zr5.BPrv1I;ohu1TvHzUM&t+S6AK94]X:Pi2& `WKOMDAV67\b9>qV;Ph*3o,yv87B"|a5N*L&^!&>ai Scan-Shipping Inc. 4201 N. Long Beach Blvd, Suite 327. ).#b The EAP works closely with individuals and families to help: EAP Specialists provide professional assessment and referral services to assist employees in developing problem resolution strategies and in linking to community resources. %U$ 1~fh~n Uv~ @| F?/Ho1zyE@&~^ F?+ygxV Download the form you want from the largest collection of templates. x=ko9?4_Ei>XLngs{3AX[Jdd?$[-Q>\R*zr[nvr-/?/l\^z|y&y/_di*,QxY|'/~~Kd KxI!T%>-,BJO/_2TNw1=\]?jrK E>;n:E_HJ>Mo6UBNn Box 181 Concord, NH 03301 Eligibility Worker . endstream endobj startxref Most scans take less than 15 minutes. STATE OF NEW HAMPSHIRE Department of Health and Human Services Division of Economic and Housing Stability Bureau of Child Development and Head Start Collaboration Form 1863 May 2020 BCDHSC Form 1863 May 2020 Mail a copy to DHHS Central Scanning Unit, P.O. ?L)8h^x3aBGN xQAmdcW2q }yB%YFY'j/QRaa O^`"=g/*nxrzdz-TE;BVXG+hi`nW'IbcAf~"KUtGd*tZF~r endobj <> Securing the data left on that old printer. 3 0 obj 1 0 obj i. BFA SR 22-31 * Forms to be completed for Adult Disability Programs* . ]k*zrG1uwL=yyrA4hPfen47}`~u[#>k%E{#QQ?xC =Qp 2G#{rY vh%1M,!V t5eZTQ"aT=@yf|3Zo9A B|vqu 2023 Capital Business Systems, Inc. | 800-221-0604, My Account (service, supplies, metering), Architecture, Engineering and Construction, Canon U.S.A. S)o vomOM~rO$Op$SM25~V W4:%,U2G|%ru cQSG;Kij"RUNr`#YDz|2)>Fx-#Oo2Zr//,_X'w`t~G:yyk.|PiH4'Z1 ~G/ iy/OPxVe Employees and departments participating in the Employee Assistance Program may be concerned about the matter of confidentiality. 1,188 Document Scanning jobs available in Kearny, NJ on Indeed.com. endobj An RAI representative will be contacting you shortly. By law, the EAP staff must notify appropriate agencies of: We are committed to the principle that any information or material we receive, other than that required by law to be reported to authorities will not be communicated to anyone without your permission. The test is more likely to be ordered in men or women with some of the following risk factors: The test can be especially important in determining the cause of unexplained chest pain. endobj The State of New Hampshire Employee Assistance Program (EAP) is designed to offer assistance to all State employees and their family members. endobj W Pc9Ix {8?fj3J1~9TS'! %PDF-1.5 RRH_T|/yEpg0VtPY>'k] endobj <> This buildup of calcified plaque in artery walls is called atherosclerosis, or hardening of the arteries. x][s8~OU!nJ*If8]S[yPbl"e9_P T;]i Types of scanners vary based on your application. family history of heart disease or heart attack. Most communications are protected by federal and state laws which assure that whatever information is given, orally or in writing, to any member of the EAP staff will not be revealed. <>>> Choose from 85,000 state-specific document templates available for download in Word and PDF format. T_'NlXZ\^VUM=xO]R":ug5z/%91x^W[?Jhc Q !, Q0u`J)Ea@Dp1 iBqdEuzt{J~T6 k1F6Qbv*jyGP9H)Te+fSCKiP}MDe_|PC}`XH'[C4k+^\^0i3t9P3Y4 syf`^LGC gd8!r;WTc,7:!(OWf@6 !d^ F%="!4gF` guiHO*U66vC7(.EcSMx>Z+e7L"0aQ 1207 0 obj <>stream While this directory is intended to provide contact information to related programs, it doesn't not include contact information for all DHHS staff members. Fax: +1 866 922 4936. lax@scan-shipping.com. Click here for our full COVID-19 response. 4 0 obj Once the scanning procedure is complete, you can resume your regular activities. The electrodes will be attached to an electrocardiograph (ECG) machine which will be used to monitor your heart's electrical signals during the CT scan so images can be made between contractions or beats. During the scan, the CT table will move you slowly through the CT scanning machine, often making several passes to obtain an entire clear series of images. 111 North Sanders Helena, MT 59601-4520 PO Box 4210 Helena, MT 59604-4210, 1400 Broadway, Rm C314, Helena, MT 59601-5231, Asthma and Diabetes Prevention and Control Programs, Nutritional and Physical Activity Program, 1400 Broadway, Room C202 Helena, MT 59601-5231 TOP, 1400 Broadway, Room B102 Helena, MT 59620, 1400 Broadway, Room C216 Helena, MT 69601-5231, 1400 Broadway, Room C216 Helena, MT 59601, Program Planning Unit 111 N Last Chance Gulch, Helena, MT 59601-6282 PO Box 8005, Helena, MT 59604-8005 TOP, Centralized Intake Unit 111 N Last Chance Gulch, Helena, MT 59601-6282 PO Box 8005, Helena, MT 59604-8005, 1625 11th Ave, Helena MT 59601 PO Box 4210, Helena MT 59620, 1625 11th Ave, Helena MT 59601 PO Box 4210, Helena MT 59620 TOP, Food Distribution/Commodity Warehouse Program 1400 Carter Drive, Helena, MT 59601-6400 PO Box 202956, Helena MT 59620-2956 TOP, Energy & Community Services Program (LIEAP & Weatherization) 1400 Carter Drive, Helena, MT 59601-6400 PO Box 202956, Helena, MT 59620-2956 TOP, Medicaid & Healthy Montana Kids Drug Rebate Program, 1400 Broadway, Room A104 Helena, MT 59601-5231, Audit Bureau 2401 Colonial Dr, 3rd Floor Helena, MT 59601-4909, Administrative Support Supervisor,Afrah Al Asadi, Administrative Assistant,Andrew Erickson, 1100 N. Last Chance Gulch, 2 nd Floor, Helena, MT 59601 TOP, State Information Technology Services Division PO Box 200113 Helena, MT 59620-0113 CONTACT US, STD DIS Program Specialist, Miranda Reddig, U.S. BUREAU OF LABOR STATISTICS FOR MONTANA, MONTANA OFFICE OF TOURISM AND BUSINESS DEVELOPMENT, MONTANA HISTORICAL SOCIETY RESEARCH CENTER, Behavioral Health and Developmental Disabilities, Office of Inspector General (formerly Quality Assurance), State Information Technology Services Division, Economic Security Services Executive Director, Erica Johnston, Medicaid and Health ServicesExecutive Director, Mike Randol, Medicaid and CHIP State Plan Amendment and Waiver Coor., Mary Eve Kulawik, Strategic Planning, Research andAnalysis, Eric Higginbotham, Operations Revenue Forecasting Specialist, Jamie Bartole, Office of Inspector General, Michelle Truax (Interim), State Medical Officer, Dr. Maggie Cook-Shimanek, Office of Health and Human Services Innovation, CIO, Marie Matthews, Legislative and Regulatory Affairs, Brenton Craggs, Communications Specialist, Herbert Council, Program Analyst/Technical Writer, Megan Grotzke, Faith and Community Based Services, Tracy Moseman, American Indian Health Director, Stephanie Iron Shooter, Chief Human Resources Officer, Karol Anne Davis, Deputy Human Resources Officer, Ciarra Krantz, Civil Rights and EEO Officer , Lloyd Sparks, Senior Human Resource Partner/Employee & Labor Relations, Sarah Green, Senior Human Resource Partner/Facility Liaison, Vacant, Human Resources Office Coordinator, Sam Askin, Risk Management and Safety Officer, Joe McAnally, Occupational Health and Safety Officer, Tawni Jo Carmody, Deputy Chief Legal Counsel, Chad G. Parker, Attorney, HIPAA Program Officer, Theran Fries, Office Manager / Administrative Rule Specialist, Valerie St. Clair, Administrative Rule Specialist, Kassie Thompson, Administrative Legal Assistant, Bailey Yuhas, Medicaid Systems Operations Manager, Shellie McCann, State MedicalDirector, Dr. Maggie Cook-Shimanek, MD, Local & Tribal Support Coordinator, Kerry Pride, DVM, System Improvement Coordinator, Terry Ray, Public Health Accreditation Coordinator, Vacant, Workforce Development Coordinator, Neva Loney, Performance Management and Information Systems Coordinator, Marilyn Trevino, State Refugee Coordinator, Kathe Quittenton, Epidemiology Program Manager, Heather Zimmerman, Office Manager/Financial Specialist, Jodee Prevel, Disability Health Education Specialist, Mackenzie Jones, Office Manager/Financial Specialist, Susan Day, Administrative Specialist, Carolyn Linden, Determinates of Health Program Manager, Margaret Mullins, Secondary Prevention Specialist, Mike McNamara, Quality Improvement Coordinator, Callan Brick, Asthma Control Program Manager, BJ Biskupiak, EMS Licensing and PI Specialist, Francine Janik, Cardiac Ready Program Manager, Janet Trethewey, Community Integrated Health Program Specialist, Kelly Little, Trauma System Manager, Alyssa Johnson, RN, BSN, Violent Death Registry Program Manager, William "Buck" Herron, Injury Prevention Coordinator, Maureen Ward, Health Education Specialist, Alivia Winters, Administrative Support/Licensing, Sandra Tirrell, Body Art/Trailer Court Camp Grounds/ Cottage Food/ Farmers Markets, Mark Hall, Wholesale Mfg. 4 0 obj NH Department of Health and Human Services DHHS Division of Family Assistance DFA DFA Form 720 02/13 rev 1/15 DETERMINATION OF INCAPACITY STATUS Name Return Completed Form to Centralized Scanning Unit CSU P. How It Works. G e8-'hfgJitS\;V:}[|XK[_. {Mi{: {9){E^V-m:RLz#ibY5c0)ysWU5 e5[]y|;[.u7\hit_2f}8|f( oA[i4p28:+;]`lFekVIHh+Z3mS)|IA snZcwh~y['vW! The health and well-being of patients is our primary concern. Amazon Fulfillment Center-Djz4. (5N' PgNrj[Wu`F(0^v?Tw|;:y^/_"/a2ke&r?6mBin@\fGt_b_=P6+Jr@%763{@]F0n) mr P%n9mMj+W@t--2{]s$pHqf8.p2f0mlUM`]RUziC7x(;Ls@*VS 0 The health and well-being of patients is our primary concern. %PDF-1.5 The CIT & Authorization mission is to promote and protect public health by: Managing Centralized Intern Training for new agents of the state to become authorized to enforce state sanitation laws and rules. |Ei=r %&gU/%v2_K?=d)7UL^_i!4?F'(ws/T%qhDBVadZJ%N#l&9$xu}"x.HEuM7$XeVqU`Uy\z>XVu(cxuf-|Kq#njrL5p9o y44 hx*4csBSsR9xFh":fl2mv qH%@9f m'}vlZeZ9RTkCV,4\1\$hZS If you test positive for COVID-19 and have symptoms, antiviral medication can help! Call 1-844-ASK-DHHS (1-844-275-3447) Tel: +1 310 634 0130. <> TO: FROM: Centralized Scanning Unit P.O. endobj NH Department of Health and Human Services (DHHS) BFA Form 765 Bureau of Family Assistance (BFA) 06/15 rev 2/19 DFA SR 15-15 Return to: Centralized Scanning Unit (CSU), P.O. NH Department of Health & Human Services (DHHS) DDU Form 177 Bureau of Family Assistance (BFA) - Disability Determination Unit (DDU) rev 12/22 Page: 1 of 9 . by Capital Business Solutions | Oct 20, 2016 | Blog. We at the Employee Assistance Program are committed to confidentiality, however it is important that you realize that even professional confidentiality has its limits. ' .GIr!~)H#H?`6h=T4hB \%,dMRU:N 3 2 0 obj Explore and apply for benefits. Adds Six New Printer and Multifunction Devices, Canon U.S.A. endobj endobj During calcium scoring, the amount of calcium in the coronary arteries is measured and a score is obtained that can help determine an individual's risk for heart attack or heart disease. Main DHHS Switchboard: (402) 471-3121. endobj Centralized Scanning - This is an environment where paper documents are sent to a central location for processing. An Employee Assistance Program (EAP) is a program that can help with everyday issues to traumatic events. collector: ethan davio phone: 603-476-2348 Long Beach, CA 90807, USA. These scanning can range from personal desktop scanners to production scanners. % stream /ag}s3'gEOBFFE{?=A7/B1`iE@x0`G@ NH Department of Health and Human Services (DHHS) DFA Form 770 Estate Recoveries Unit/Division of Family Assistance (DFA) 11/11 rev 1/15 rev2 9/16 Return to: Centralized Scanning Unit (CSU), P.O. endobj The images will be analyzed by the CT scanner software to assess the number of plaques, their density and their distribution so a final calcium score can be determined. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %%EOF A family member is extended the same rights of confidentiality as the employee, and of course, the program is voluntary for family members as well. Page 1 of 2. New Hampshire Employment Verification Letter for Social Security If finding legal forms online looks like a problem, use US Legal Forms. endobj When starting off on your search for a scanner, it is important to know the difference between centralized scanning and decentralized scanning. Apply to Medical Technician, Concierge, Document Specialist and more! }G~8Y-m)5j@7'023jPCLYI1*mMZg kM$u:)X@*=pg" 3v~=wmnj{cnIX^ G96"g !R Services are available to all NH state government employees and their family members.
