FASD CASE MANAGEMENT SERVICESProvider Agreement • December 18th, 2013
, (Provider) enters into a Provider Agreement with the State of Alaska, Department of Health & Social Services (DHSS) for the purpose of providing FASD case management services to individuals previously diagnosed with FASD by a FASD team supported by a state provider agreement, for the State of Alaska’s FASD Case Management Services Program. By entering into this Provider Agreement, the Provider agrees to the following, including all applicable provisions of the following Appendices and Attachments: