FASD DIAGNOSTIC SERVICES PROVIDER AGREEMENTDiagnostic Services Provider Agreement • September 17th, 2021
, (Provider) enters into a Provider Agreement with the State of Alaska, Department of Health & Social Services (DHSS) for the purpose of providing Fetal Alcohol Spectrum Disorders (FASD) diagnostic services to referred individuals for the State of Alaska’s Statewide FASD Program. By entering into this Provider Agreement, the Provider agrees to the following, including all applicable provisions of the following Appendices:
State of Alaska, Department of Health and Social Services Division of Behavioral Health Grants & Contracts Support Team FASD DIAGNOSTIC SERVICES PROVIDER AGREEMENTDiagnostic Services Provider Agreement • November 5th, 2020
_________________________________________, (Provider) enters into a Provider Agreement with the State of Alaska, Department of Health & Social Services (DHSS) for the purpose of providing FASD Diagnostic Services to referred individuals for the State of Alaska’s Statewide FASD Diagnostic Services Program. By entering into this Provider Agreement, the Provider agrees to the following, including all applicable provisions of the following Appendices:
