RFQ 1236-427 - Request for Qualification, DDDS Consultative Psychiatric Exams
Notice:
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Purpose
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The Department of Social and Health Services (DSHS), Division of Disability determination Services (DDDS), administers the Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and DSHS Non-Grant Medical Assistance programs. The purpose of this Request for Qualifications (RFQ) is to expand the list of qualified, contracted psychiatrists to perform diagnostic examinations for clients who apply for these benefits. |
Contact Name |
Uyen Kashani, Professional Relations Specialist |
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Contact Email and Address
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Uyen.Kashani@ssa.gov
Department of Social and Health Services Division of Disability Determination Services P.O. Box 9303 Olympia, WA 98507-9303 |
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Contact Phone
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1-800-562-6074, Ext. 47437 |
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Contact Fax
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(360) 664-7359 |
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Submissions
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If you are interested in becoming a Consultative Examiner, please submit your application packet to the above address or fax number. |
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Issue Date
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February 12, 2013 |
Documents:
RFQ 1236-427 - Legal Notice - February 12, 2013
RFQ 1236-427 - Request for Qualification, DDDS Consultative Psychiatric Exams
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Exhibit A - Application Checklist
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Exhibit B - Acknowledgement of Professional Qualifications & Confidentiality
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Exhibit C - Statement of Agreement for Medical Providers
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Exhibit D - Contractor Intake Form
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Exhibit E - Sample Contract – Consultative Psychiatric Examination
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Exhibit F - Medical Source Statement of Ability to do Work-Related Activities
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