Documents

File Name	File	Category	Date	File Format
CFC & TBI Provider Enrollment Process	CFC & TBI Provider Enrollment Process.pdf		13 Jul 2018	PDF
CFC 700 Adult Family Care Tier Score Sheet	CFC_700_Adult_Family_Care_Tier_Scoresheet.pdf	Form	02 Aug 2018	PDF
CFC 706 Adult Family Care Referral Form - 2018	CFC706_AFC_AA_Referral_V12-2018	Form	02 Jun 2020	PDF
CFC 804 Admission to Services Form	CFC_804_Admission to Services Form.pdf	Report	01 Apr 2019	PDF
CFC 804 Form Process 2019	CFC.804.Form_.Process.2019.pdf		04 Apr 2019	PDF
CFC 804 Forms Instructions	VT_CFC_804_Forms_Instructions_3.2019 (003).pdf		01 Apr 2019	PDF
CFC 804 Home-Based & ERC Change Form	CFC_804_HB_ERC_AFC_change_report.pdf	Form	18 Apr 2016	PDF
CFC 804A Termination of Services Form	CFC_804A_Termination_of_Services.pdf	Form	01 Apr 2019	PDF
CFC 804B Nursing Home Change of Payment Form	CFC_804B_NH_Change_of_Payment.pdf	Form	01 Feb 2019	PDF
CFC 804C Short-Term Medicaid Only Rehab Form	CFC_804C_Short-Term Medicaid Only Rehab Form (2).pdf	Form	01 Apr 2019	PDF

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