Department of Health and Social Services

Official Website: http://dhss.alaska.gov

The mission of the Department of Health and Social Services is to "promote and protect the health and well-being of Alaskans."

Provides to all eligible Alaskans access and oversight to the full range of appropriate Medicaid services. We also protect Alaska’s most vulnerable populations through our certification and licensing sections.

Forms & Documents

Browse all Department of Health and Social Services government forms

21 - 40 of 112 forms

Form Title Topics
Eligibility Determination and Request for Services Application
EMOD Review Tool (Guide for EM planning)
Environmental Questionnaire?
FA/CPR Remote Allowance for Continuing Personal Care Assistants
FA/CPR Waiver for First Time Personal Care Assistants
Family Home Habilitation Site Information/Change of Status Report
First Aid Training Verification – Suggested Format
GR for ALC Client Activity Form
Group Home Habilitation Site Information/Change of Status Report
Guidelines for ICAP Process
Guidelines for QDC Form
ICAP Assessment Information and Consent
ICF/IID Level of Care Determination
Individual Care Coordinator Conflict of Interest Assurance
Initial and Renewal ICAP Application Checklist
Initial Application for General Relief Assisted Living Care
Initial Renewal ?Interim Application Checklist
Instructions for requesting EMOD estimates
Interim ICF/IID Level of Care
List of acceptable CPR and First Aid courses taught by licensed/certified agencies

Contact Information & Office Locations

All 3 contact points

Main Office

Address:
350 Main Street
Room 404
PO Box 110601
Juneau, AK 99811-0601

Phone numbers:
  • (907) 465-3030

Address:
Administration
P.O. Box 110620
Juneau, AK 99811-0620

Phone numbers:
  • (907) 465-8202
Fax numbers:
  • (907) 465-2185

Address:
Behavioral Health Office
3601 C Street
Suite 878
Anchorage, AK 99503

Phone numbers:
  • (907) 269-3600
Fax numbers:
  • (907) 269-3623

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