Skip Persistant Navigation
Search DHHS:
DHHS Home

Information For:

Inside DHHS

Helpful Links

 
  Home >> Resource Library >> Forms

Applications & Forms

For Beneficiaries


Civil Rights Discrimination Complaint
If you have questions about this form, call SCDHHS at (803)898-2605. Return the completed form to: Office for Civil Rights, SCDHHS, PO. Box 8206, Columbia, SC 29202-8206

Privacy Complaint Form
Health Information Privacy Complaint. If you have questions about this form, call SCDHHS OCR at (803) 898-2605. Return the completed form to: Office for Civil Rights, SCDHHS, P.O. Box 8206, Columbia, SC 29202-8206
Health Care Power of Attorney

Description: Information about and form for Health Care Power of Attorney- see section 62-5-504.
Posted: 1/15/2008 4:04:46 PM
Living Will

Description: Form for Declaration of Desire for a Natural Death.
Posted: 4/10/2003 12:04:45 PM
Disclaimer:

These forms are statutory and may not meet your particular needs. Before you complete and sign these forms, you should consult with an attorney to determine if some other document would better meet your needs.


For Providers

Medicare & Health Insurance Carrier Code Lists

Hurricane Katrina Uncompensated Care Pool (UCCP)

Request Form for Reimbursement of Uncompensated Care

Some documents require other software
Get Adobe Reader Excel Viewer 2003 Word 2003 viewers



Skip Persistent Navigation
Home | Inside DHHS | Programs and Services | Contact DHHS | Site Map   
This Web site has both active pages and archives.
Please be certain to check the date of each release.
There may have been a bulletin released or a provider manual update
that supercedes the information found on this page.
Privacy Policy   |   SCDHHS Notice of Privacy Practices

SCDHHS Notificacion de Practicas de Privacidad

Authorization to Disclose Health Information

Experiencing Problems with our website?
Please tell us.
Copyright © 2010 All Rights Reserved.

Department of Health and Human Services
P. O. Box 8206
Columbia, SC 29202-8206

The general phone number is (803) 898-2500
Fraud (888) 364-3224
Medicaid Beneficiaries (888) 549-0820

SC DHHS HIPAA Website

To ask questions about the agency, programs, or services,
email info@scdhhs.gov.

If you have comments, questions or suggestions, regarding this website
email webmaster@scdhhs.gov.

SC State Government Site.
SC.GOV