Material Incorporated by Reference Main ContentThe materials and forms listed below are referenced in the Kentucky Administrative Regulations of the Office for Children with Special Health Care Needs.911 KAR Chapter 11:010 Application to Clinical ProgramsOCSHCN-10a, Application for Service Legal GuardianOCSHCN-10b, Consent for CareOCSHCN-10c, Guaranty of Payment AgreementOCSHCN-10d, Coordination of Benefits AgreementOCSHCN-10e, Application for Service Young AdultOCSHCN-10f, Application for Service Head of HouseholdOCSHCN-10g, Medical Eligibility List for Clinical and Case Management ServicesOCSHCN-10h, Medical Expense WorksheetFamily Participation Scale1:020 Billing and Fees OCSHCN-20a, Request for Reconsideration of Discharge1:060 Medical StaffOCSHCN-60a, Application for Active Medical or Dental StaffOCSHCN-60b, Application for Active Medical APRN StaffOCSHCN-60c, Application for Active Psychology StaffOCSHCN-60d, Application for Active Medical Physician Assistant StaffOCSHCN-60e, Authorization, Attestation, and ReleaseOCSHCN-60f, Anti-Harassment and Discrimination AcknowledgmentOCSHCN-60g, Peer Reference Letter Medical or DentalOCSHCN-60h, Peer Reference Letter PsychologistOCSHCN-60i, Renewal Application for Active Medical or Dental StaffOCSHCN-60j, Facility Recommendation LetterOCSHCN-60k, Request for Reconsideration by Medical Advisory Committee1:085 EHDIGuidelines for the Audiologic Assessment of Children From Birth to 5 Years of AgeOCSHCN E106 QuestionnaireE-107 Audiological Center Modification 2022Guidelines for the Audiologic Assessment of Children from Birth to 5 Years of Age - ASHA 2004JCIH 2019 Relative ContentCommonwealth of Kentucky Administrative Regulations Full text of KAR Title 911 Additional Information Contact Information Related Agencies Office for Children with Special Health Care Needs Department for Community Based Services DPH Division of Maternal and Child Health