1871. Infertility Treatment & Procedures Disclosure Form - Connecticut
INSTRUCTIONS: CONNECTICUT INFERTILITY TREATMENT AND PROCEDURES DISCLOSURE FORM Connecticut individuals seeking health insurance coverage for infertility treatment and procedures are required to file a form disclosing any ...
1872. External Review Application Form - Connecticut
INSTRUCTIONS: CONNECTICUT REQUEST FOR EXTERNAL REVIEW A Connecticut patient who has been denied health insurance coverage for a procedure may request an external review from the state's Insurance Department by using ...
1873. External Review Consumer Guide - Connecticut
1874. CT Surety Liquidation Claim Form - Connecticut
INSTRUCTIONS: CONNECTICUT PROOF OF CLAIM (SURETY LIQUIDATION) This article discusses a proof of claim form that was made available following the liquidation of the Connecticut Surety Corporation and related affiliates. T ...
1875. Consumer Complaint Form - Connecticut
INSTRUCTIONS: CONNECTICUT CONSUMER COMPLAINT FORM To file a complaint regarding denial of insurance coverage in Connecticut, use the form discussed in this article. This document can be obtained from the website of the g ...
1876. Discrimination Complaint/Federal Grants - Connecticut
INSTRUCTIONS: CONNECTICUT DISCRIMINATION COMPLAINT/FEDERAL GRANTS To file a complaint in Connecticut regarding discrimination by a program or activity supported by the U.S. Department if Justice, use the form discussed i ...
1877. Grievance Complaint (Supreme Court or Appellate Court) filed under the Americans With Disabilities Act - Connecticut
INSTRUCTIONS: CONNECTICUT GRIEVANCE COMPLAINT (SUPREME COURT OR APPELLATE COURT) FILED UNDER THE AMERICANS WITH DISABILITIES ACT Connecticut residents who believe they have been the victim of a discriminatory act or deci ...
1878. Magistrate Application — Authorization For Release of Information - Connecticut
1879. Application For Appointment as a Magistrate - Connecticut
1880. Request For Accommodation By Persons With Disabilities - Connecticut
INSTRUCTIONS: CONNECTICUT REQUEST FOR ACCOMMODATION BY PERSONS WITH DISABILITIES (Form JD-ES-264) To request reasonable accommodation for a person with disabilities as defined by the Americans With Disabilities act at a ...