DSHS - DDDS Consultative Psychiatric Examinations

Purpose	The Department of Social and Health Services (DSHS), Division of Disability Determination Services(DDDS) administers the Social Security Disability Insurance (SSDI), Supplemental Security Income Disability (SSI) benefits and the DSHS Non-Grant Medical Assistance program. The purpose of this Request for Qualifications is to expand the list of qualified, contracted physicians to perform psychiatric diagnostic interviews for clients who apply for these benefits.
Contact Name	Ladd Wikstrom, Contracts Specialist
Contact Email	ladd.wikstrom@ssa.gov
Contact Phone	360.664.7523
Issue Date	April 16, 2007
Bidder Questions Due	N/A
Answers Released	N/A
Proposal Due Date	N/A

RFQ Exhibit A - Exhibit A - Application Checklist (Updated May 2011)
RFQ Exhibit B - Acknowledgement of Professional Qualification and Confidentiality (Updated May 2011)
RFQ Exhibit C - Statement of Agreement for Medical Providers (Updated May 2011)
RFQ Exhibit D - Contractor Intake Form
RFQ Exhibit E - Sample Contract (Updated May 2011)
RFQ Exhibit F - Adult Psychiatric Evaluation Guidelines (Updated May 2011)
RFQ Exhibit G - Child Mental Evaluation Guidelines (Updated May 2011)
RFQ Exhibit H - Medical Source Statement of Ability To Do Work-Related Activities (Updated May 2011)
RFQ Exhibit I - L9 Consultative Examination Voucher (Updated May 2011)

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