1. The AHCA 5000-3008 form must be filled out in a complete and accurate manner. 2. Use Form 8962 to figure the amount of your premium tax credit.(PTC) and reconcile it with advance payment of the premium tax credit (APTC). Press 1 to report suspected abuse, neglect or abandonment of a child. A. DOEA Screening Form 701S is used for screening and re-screening individuals for enrollment and maintenance on the Assessed Prioritized Consumer List. 825.1025 Lewd or lascivious offenses committed upon or in the presence of an elderly person or disabled person. Elder Options Intake Pre-Screening Form. This form must be fully completed. 2 Read and write multi-digit numbers with decimals to the thousandths using standard form, word form, and expanded form. Providers sending professional and supplier claims to Medicare on paper must use Form.