South Carolina Medicaid Funding Forms

Required Funding Forms

These forms are required by your state’s Medicaid program in addition to the standard funding forms listed below. Please make sure to download all forms as a PDF and fill in the forms electronically. Save as needed before submitting to Forbes AAC.

Read Me First - Florida Medicaid and MCOs

If the client has Florida Medicaid, this is recommended as to the purchase of equipment and should be read first to provide a brief background on the details.

Florida School Concurrence Form

If the Client is of school age, and has Florida Medicaid, completion of this form is also required.

If the client has Medicare as an additional funding source, please be advised that Face-to-Face notes must be completed is addition to the standard funding paperwork.

Standard Funding Forms

The forms listed below must be received to complete your funding packet request. Once we have received all of the listed items, a funding expert will review your documentation to determine if any alterations are required prior to submission. We encourage all of our customers to reach out to us with any questions that you may have! NOTE: Spanish forms are available for the Client Information Form, the Feature Unlock Key and the Release of Information (ROI) and Assignment of Benefits Form (AOB).