CSD Aged, Blind or Disabled (ABD) Program Medical Evidence Reviews

Purpose	The Department of Social and Health Services (DSHS), Community Services Division (CSD), provides multiple programs to support the mission of DSHS. The purpose of this Request for Qualification (RFQ) is to expand the list of qualified physicians and psychologists to use their diagnostic and clinical expertise to evaluate a client’s claimed mental or physical impairment by reviewing medical evidence provided by CSD.
Contact Name	Bryan Tso, Social and Health Program Consultant
Contact Email and Address	Bryan.Tso@dshs.wa.gov Department of Social and Health Services Economic Services Administration P.O. Box 45470 Olympia, WA 98504-5470
Contact Phone and Fax	(253) 725-7627 - Office (360) 725-4904 - Fax
Submissions	If you are interested in providing consultative services, please submit your application packet to the above address or fax number.

Documents

Exhibit A – Application Checklist
Exhibit B – Statement of Agreement Form
Exhibit C – Contractor Intake Form
Exhibit D – Sample Contract – Aging, Blind or Disabled (ABD) Medical Evidence Reviews
Exhibit E – Applicant Certification and Assurances Form