Daim Ntawv Pab Dawb CEEB TOOM: Daim foos no tsis sib haum nrog Internet Explorer (IE). Thov siv lwm qhov browser, xws li Mozilla, Chrome, lossis Ntug. Kauj ruam 1 of 12 8% Ua tsaug rau koj qhov kev txaus siab rau kev ua haujlwm pub dawb ntawm Aging & Disability Resource Center. Ib txwm xav tau cov neeg tuaj yeem pab dawb los pab cov neeg laus thiab cov neeg laus uas muaj kev tsis taus los ua lub neej muaj txiaj ntsig, muaj kev ywj pheej. Koj tuaj yeem paub tseeb tias koj cov kev pabcuam yuav txhais tau tias muaj txiaj ntsig zoo rau cov neeg koj ua haujlwm. Txawm hais tias koj lub siab nyiam, txawm tias koj tuaj yeem pab ua ntu zus lossis hloov pauv thaum koj tuaj yeem ua tau, koj cov kev pabcuam pub dawb yuav zoo siab heev.Thov ua kom tiav thiab xa cov hauv qab no: Daim Ntawv Pab Dawb Daim ntawv qhia tsis pub lwm tus paub & tsis sib haum xeeb ntawm kev txaus siab Cov ntaub ntawv keeb kwm nthuav tawm Kev cob qhia txhua xyoo HIPAA Luam daim ntawv tsav tsheb Tub ceev xwm pov thawj ntawm Auto Insurance (los yog nplooj ntawv tshaj tawm) CEEB TOOM: ADRC yuav tsum muaj cov ntaub ntawv pov thawj tshiab ntawm kev pov hwm kev pov hwm rau txhua tus neeg tuaj yeem pab dawb. Koj yuav raug xa ib daim ntawv thov rau cov ntaub ntawv pov thawj tshiab ntawm kev tuav pov hwm ob xyoos lossis ib xyoos. Daim ntawv theej ntawm daim npav pov hwm yuav tsum qhia hnub tas sij hawm rau koj txoj cai tam sim no. Yog tias tsis yog, koj tuaj yeem hu rau koj tus neeg saib xyuas kev pov hwm thiab hais kom lawv xa peb "Certificate of Insurance". (Peb tuaj yeem luam koj daim ntawv tsav tsheb thiab cov ntaub ntawv pov thawj yog tias koj coj lawv mus rau ADRC).Ua li cas tom ntej no? Peb yuav sau koj cov ntaub ntawv keeb kwm yav dhau los thiab hu rau koj cov ntaub ntawv. Thaum tau txais tag nrho cov khoom no, peb yuav tiv tauj koj hauv xov tooj lossis xa ntawv nrog cov xwm txheej ntawm koj daim ntawv thov. Cov ntaub ntawv thov pab dawbHnub(Yuav tsum tau) Lub npe Tag Nrho(Yuav tsum tau) chaw nyob(Yuav tsum tau) Chav tsev / Chav tsev # txoj kev xav(Yuav tsum tau) State(Yuav tsum tau)AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareKoog tsev kawm ntawv ntawm ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireTshiab JerseyTshiab MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCov Tub Rog Rog (Armed Forces)Tebchaws Armed Tebchaws EuropeRog Pacific (Armed Forces Pacific)Zip Code(Yuav tsum tau) xov tooj(Yuav tsum tau) Xov Tooj Hom(Yuav tsum tau) cell landline Peb puas tuaj yeem sau ntawv rau koj? Yog Tsis yog email chaw nyob Emergency Contact Name & Kev sib raug zoo(Yuav tsum tau) Xovtooj xwm ceev(Yuav tsum tau) Kev Kawm - Ntawv pov thawj - Daim ntawv tso caiThov suav tag nrho cov ntawv pov thawj, ntawv tso cai, thiab/lossis kev kawm uas koj muaj:Koj puas paub hom lus thib ob? Yog Tsis yog Lus dab tsi? References Thov sau peb cov ntaub ntawv ua tiav nrog rau kev ua haujlwm pub dawb thiab kev ua haujlwm, yog tias muaj. Txhua cov ntaub ntawv sau tseg yuav raug hu.Lub npe Tag Nrho(Yuav tsum tau) Xyoo Paub(Yuav tsum tau) Kev sib raug zoo(Yuav tsum tau) xov tooj(Yuav tsum tau) Tag Nrho Chaw Nyob(Yuav tsum tau) Email Lub npe Tag Nrho(Yuav tsum tau) Xyoo Paub(Yuav tsum tau) Kev sib raug zoo(Yuav tsum tau) xov tooj(Yuav tsum tau) Tag Nrho Chaw Nyob(Yuav tsum tau) Email Lub npe Tag Nrho(Yuav tsum tau) Xyoo Paub(Yuav tsum tau) Kev sib raug zoo(Yuav tsum tau) xov tooj(Yuav tsum tau) Tag Nrho Chaw Nyob(Yuav tsum tau) Email Kev Ua Haujlwm Yav Dhau Loslub tuam txhab xov tooj chaw nyob Tus Saib Xyuas Txoj hauj lwm Title Luag Hauj LwmHnub Ua Haujlwm Tub RogNcau ceg Los ntawm Yuav Rank ntawm Discharge Hom Kev Tso Tawm Yog tias tsis yog kev hwm, thov piav qhia Volunteer Placement Preference & Availability Thov sau 1st, 2nd, 3rd, thiab 4th xaiv. Kev ua haujlwm pab dawb muaj nyob txawv raws li qhov xav tau.Ua haujlwm pub dawb txaus siab1st Xaiv2nd XaivKev xaiv thib 34th XaivTsis Txaus SiabNoj movPab Tus Thawj Coj Ua SiNtim Khoom Noj Hauv TsevGrounded Café Food PrepTechnology InstructorKev tawm tswv yim/FundraisingKev Tiv Thaiv Kev Noj Qab Haus Huv Tus Thawj CojLus txawv teb chawsProgramming/EventsKev nthuav dav ntawm MedicareKev Lag Luam & TsimTus Thawj CojUa haujlwm pub dawb txaus siabLwm yam kev txaus siabCov txuj ci tshwj xeeb, kev nyiam ua, lossis kev txawj ntseThov sau tag nrho cov kev txwv & kev txwv(Qhov kev pab tsim nyog rau kev tsis taus yog muaj. Thov thov ntawm no yog tias xav tau.)Hnub (s) ntawm Lub Limtiam Muaj Monday Tuesday Wednesday Thursday Friday Saturday Sijhawm (s) Muaj Koj puas tsav tsheb / muaj tsheb?(Yuav tsum tau) Yog Tsis yog Cov ntaub ntawv pov hwm tsheb Kuv nkag siab tias yog tias kuv siv kuv tus kheej lub tsheb hauv kuv qhov Kev Pabcuam Dawb Huv, kuv yuav npaj kom muaj kev tuav pov hwm tsheb muaj feem cuam tshuam nrog rau qhov tsawg kawg nkaus uas peb lub xeev xav tau. (Thov xa ib daim qauv ntawm koj daim npav pov hwm lossis "daim ntawv tshaj tawm nplooj ntawv" lossis kom koj tus neeg tuav pov hwm xa tuaj rau peb "Certificate of Insurance" ntawm koj txoj cai.)Daim ntawv tsav tsheb # Daim Ntawv Tso Cai # muab zaisKoj xav xa koj cov ntaub ntawv li cas? Upload online Tawm ntawm ADRC Upload ib daim qauv ntawm koj daim ntawv tsav tsheb ntawm noMax. cov ntaub ntawv loj: 300 MB.Upload ib daim qauv ntawm koj daim npav tuav pov hwm tsheb lossis "cov ntawv tshaj tawm nplooj ntawv" ntawm noMax. cov ntaub ntawv loj: 300 MB. Thov nyeem cov nqe lus hauv qab no ua ntej kos npe Kuv tso cai rau Aging & Disability Resource Center hu rau cov ntaub ntawv sau tseg hauv daim foos no. Kuv tso cai rau lub chaw haujlwm no los tshawb xyuas kuv keeb kwm yav dhau thiab tus cwj pwm, seb cov ntaub ntawv no puas yog ntaub ntawv pej xeem lossis tsis yog. Kuv tso cai rau Lub Chaw Pabcuam Kev Laus & Kev xiam oob khab ua daim ntawv tsav tsheb, yog tias tsim nyog. Kuv lees paub tias kuv cov lus nyob hauv daim ntawv thov no yog qhov tseeb, ua tiav thiab raug raws li qhov kuv paub thiab ntseeg thiab nkag siab thiab pom zoo tias txhua qhov ua txhaum cai lossis tsis lees qhov tseeb ntawm daim ntawv thov no yog qhov laj thawj rau kev tsis lees lossis txiav tawm los ntawm txoj haujlwm pub dawb no. Kuv thov txim uas tsis pom zoo rau thiab tso cai rau kev siv thiab luam tawm los ntawm Lub Chaw Saib Xyuas Kev Laus thiab Neeg Xiam Oob Qhab, lossis ib tug neeg raug tso cai los ntawm lawv, ntawm ib qho thiab txhua daim duab uas lawv tau coj los ntawm kuv, rau kev tso tawm, tshaj tawm, tshaj tawm lossis lwm yam laj thawj txhua yam uas tsis muaj kuv lub npe, tsis muaj nyiaj them rov qab rau kuv, thiab tsis muaj kev kuaj xyuas ntxiv los ntawm kuv.Kos Npe(Yuav tsum tau)Los ntawm kev ntaus koj lub npe, koj tau kos npe hauv electronically kos npe rau daim ntawv no. Kev cog lus rau kev tsis sib cais Raws li Civil Rights Compliance Standards, koj yuav tsis raug tsis lees paub cov kev pabcuam lossis kev ntxub ntxaug vim yog kev ntseeg, hnub nyoog, haiv neeg, poj niam txiv neej, kev tsis taus, lub cev nqaij daim tawv, kev xav ntawm kev sib deev, lossis kev loj hlob tsis taus. Cov kev pab tsim nyog yuav raug tsim rau kev xiam oob khab raws li Americans with Disabilities Act. Yog tias koj xav tau qhov chaw nyob zoo li no, thov hu rau Aging & Disability Resource Center 72 teev ua ntej xav tau kev pab. Yog tias koj raug tsis pom zoo cov kev pab cuam vim li cas thiab xav ua daim ntawv tsis txaus siab, koj tuaj yeem tau txais ib daim qauv ntawm daim foos no los ntawm kev hu rau (920) 448-4300. Hu rau 711 Relay rau kev pab TTY uas tsis hnov lus. Aging & Disability Resource Center yog ib lub chaw muaj vaj huam sib luag rau tus tswv hauj lwm thiab tus neeg muab kev pab ua raws li txoj kev npaj ua tiav. Raws li tus neeg sawv cev ntawm Lub Chaw Pabcuam Kev Laus thiab Kev xiam oob khab ntawm Brown County, los ntawm kev kos npe hauv qab no, kuv tso cai rau kuv tau tshuaj xyuas thiab tau txais kev cob qhia ntawm ADRC Txoj Cai Tswjfwm Ntiag Tug thiab Tsis Txaus Siab ntawm Kev Txaus Siab, thiab pom zoo ua raws li nws cov kev cai. Yog tias kuv tsis nkag siab tag nrho cov cai no lossis lawv cuam tshuam li cas rau kuv txoj haujlwm lossis kev koom tes nrog ADRC, kuv yuav tsis kos npe rau nqe lus no kom txog thaum kuv tau tham nrog ADRC Tus Thawj Coj, thiab kuv nkag siab cov cai no. Kuv lees paub lub luag haujlwm ntawm ADRC cov neeg ua haujlwm los ua lub hom phiaj, cov neeg siv khoom lag luam thiab ywj pheej ntawm Managed Care Organizations (MCOs), IRIS Consultant Agencies (ICAs) thiab lwm cov chaw muab kev pabcuam lossis cov kev pabcuam uas cov neeg siv khoom tuaj yeem raug xa mus. Kuv lees paub tias kuv yuav tsum tau saib xyuas Txoj Cai Tsis Txaus Siab ntawm Txoj Cai Lij Choj, Txoj Cai Tswjfwm Ntiag Tug, thiab HIPAA Kev cob qhia txhua xyoo.Tsis pub twg paub & tsis sib haum xeeb ntawm kev txaus siab Thov nyeem cov ntaub ntawv ntawm qhov txuas hauv qab no ua ntej kos npe. Nyem qhov noKos Npe(Yuav tsum tau)Los ntawm kev ntaus koj lub npe, koj tau kos npe hauv electronically kos npe rau daim ntawv no. Daim ntawv qhia txog keeb kwm yav dhau Daim ntawv qhia keeb kwm yav dhau los yuav raug xa tuaj rau koj tom qab koj ua tiav daim ntawv thov tuaj yeem pab dawb. Qhov no yuav tsum tau ua kom tiav thiab xa rov qab ua ntej koj daim ntawv thov tuaj yeem ua tiav. Ua tsaug!muab zaisKoj xav xa daim ntawv no li cas? Upload online Tawm ntawm ADRC muab zaisRub tawm daim ntawv qhia keeb kwm yav dhau los (BID) ua tiav ntawm no(Yuav tsum tau)Max. cov ntaub ntawv loj: 300 MB.muab zaisNtxiv BID daim foos docs (yog xav tau)Max. cov ntaub ntawv loj: 300 MB.muab zaisPom(Yuav tsum tau) Los ntawm kev khij lub npov no, koj nkag siab tias koj yuav tsum xa koj daim ntawv qhia keeb kwm yav dhau los ua ntej xa. Yog tias daim foos no tsis tau muab xa mus, koj daim ntawv thov yuav tsis raug ua tiav. HIPAA Training & Test Nyeem cov ntaub ntawv HIPAA Training nram qab no thiab tom qab ntawd ua kom tiav cov lus nug hauv qab no. HIPAA Kev cob qhiaHIPAA Training TestQhov twg hauv qab no tuaj yeem yog qhov piv txwv ntawm kev ua txhaum PHI?(Yuav tsum tau) PHI fax mus rau qhov tsis ncaj ncees lawm PHI tau tso tseg tsis muaj neeg saib xyuas lossis tsis muaj kev nyab xeeb Sib tham txog PHI hauv qhov chaw pej xeem Qhia tawm lossis nkag mus rau cov ntaub ntawv yam tsis muaj "yuav tsum paub" Tag nrho cov saum no Koj qhia txog kev ua txhaum cai PHI rau leej twg?(Yuav tsum tau) Lwm tus neeg pab dawb Cov xov xwm Koj tus thawj saib xyuas qhov kev pab cuam lossis tus neeg ua haujlwm pab dawb Koj tus phooj ywg lossis tus txij nkawm HIPAA sawv cev rau dab tsi?(Yuav tsum tau) Healthy Information Program Access Administration Kev Tuav Pov Hwm Kev Noj Qab Haus Huv thiab Kev Lav Ris Health Internal Privacy Administration Act Tsis muaj cov saum no Qhov tseeb lossis cuav: Nws yog qhov zoo los nrhiav ADRC cov neeg siv khoom PHI cov ntaub ntawv txawm tias nws tsis yog ib feem ntawm kuv txoj haujlwm ua haujlwm pab dawb.(Yuav tsum tau) muaj tseeb cuav Qhov twg muaj tseeb yog tias kuv koom nrog kev ua txhaum HIPAA?(Yuav tsum tau) A. Kuv tsis muaj lub luag haujlwm ntawm tus kheej B. Tej zaum kuv yuav raug nplua rau pej xeem ntawm $100 txog $50,000 rau ib qho ua txhaum cai thiab txog li $1.5 lab toj xyoo C. Kuv yuav raug txim txhaum cai txij li $50,000 thiab nyob rau hauv tsev lojcuj ib xyoos txog $250,000 thiab raug kaw kaum xyoo D. Ob leeg B thiab C Kuv tau ua tiav HIPAA kev qhia txog kev ceev ntiag tug thiab kuv pom zoo ua raws ADRC ntawm Brown County txoj cai ntiag tug thiab kev ceev ntiag tug.Kos Npe(Yuav tsum tau)Los ntawm kev ntaus koj lub npe, koj tau kos npe hauv electronically kos npe rau daim ntawv no. 81334
