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Tools, forms and resources for Ryan White Provider use are available below. To be notified via email when new information is posted, click here.

collapse Category : CAREWare ‎(2)
CAREWare Agency Agreement.pdfCAREWare Agency Agreement.pdf47 KB
CAREWare User Agreement.pdfCAREWare User Agreement.pdf63 KB
collapse Category : Forms ‎(12)
Case Management Assessment Form.docCase Management Assessment Form.doc512 KB
Case Management Intake Form.docCase Management Intake Form.doc88 KB
Certified Transportation Referral Form.docCertified Transportation Referral Form.doc201 KB
CertifiedReferralForm.docxCertifiedReferralForm.docx26 KB
Client Eligibility Requirements.pdfClient Eligibility Requirements.pdf60 KB
Client Individualized Care Plan.docClient Individualized Care Plan.doc40 KB
Client Level Data Certified Referral Form.xlsClient Level Data Certified Referral Form.xls39 KB
Client Reassessment Form.pdfClient Reassessment Form.pdf196 KB
Client Rights and Responsibilities.docClient Rights and Responsibilities.doc41 KB
Federal Poverty Level.xlsFederal Poverty Level.xls32 KB
General Consent Form.docGeneral Consent Form.doc41 KB
Provider General Referral Form.docProvider General Referral Form.doc343 KB
collapse Category : Handbook ‎(1)
Case Management Handbook.pdfCase Management Handbook.pdf978 KB
collapse Category : Monitoring Tools ‎(17)
Ambulatory Care.xlsAmbulatory Care.xls74 KB
Case Management.xlsCase Management.xls72 KB
EIS Tool.xlsEIS Tool.xls69 KB
Fiscal Monitoring Tool.xlsFiscal Monitoring Tool.xls95 KB
Food.xlsFood.xls71 KB
General Monitoring Report.xlsGeneral Monitoring Report.xls95 KB
Health Insurance.xlsHealth Insurance.xls70 KB
Housing.xlsHousing.xls66 KB
Legal Services.xlsLegal Services.xls68 KB
Medical Nutritional Therapy.xlsMedical Nutritional Therapy.xls66 KB
Medications Drug Reimbursement Program.xlsMedications Drug Reimbursement Program.xls68 KB
Mental Health.xlsMental Health.xls64 KB
Oral Health Care.xlsOral Health Care.xls63 KB
Outreach.xlsOutreach.xls69 KB
Psychosocial Support.xlsPsychosocial Support.xls71 KB
Substance Abuse.xlsSubstance Abuse.xls64 KB
Transportation - Contracted.xlsTransportation - Contracted.xls68 KB
collapse Category : Procedure/Guidance ‎(7)
2010 Transportation Procedure.pdf2010 Transportation Procedure.pdf185 KB
Dental Referrals.pdfDental Referrals.pdf461 KB
Establishing an URN.pdfEstablishing an URN.pdf67 KB
Eye Care Referral.pdfEye Care Referral.pdf231 KB
Formula for Determining Number of Files to Monitor.pdfFormula for Determining Number of Files to Monitor.pdf61 KB
Invoice-Billing Proceedure.pdfInvoice-Billing Proceedure.pdf29 KB
Undetectable Viral Loads and Visit Requirements.pdfUndetectable Viral Loads and Visit Requirements.pdf87 KB
collapse Category : Quality ‎(1)
Quality Management Report.pdf
Checked Out To: Houser, LorraineQuality Management Report.pdf
Checked Out To: Houser, LorraineQuality Management Report.pdf104 KB
collapse Category : Reports ‎(2)
MAI Quarterly Report.docMAI Quarterly Report.doc767 KB
Part A Quarterly Report.docPart A Quarterly Report.doc767 KB
collapse Category : Standards of Care ‎(3)
Standard of Care - Case Management.pdfStandard of Care - Case Management.pdf331 KB
Standard of Care - Food Service.pdfStandard of Care - Food Service.pdf331 KB
Standard of Care - Housing.pdfStandard of Care - Housing.pdf326 KB

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