Section 1:Required for all clients

This short Form of the DAAS-101 Client Registration Form may only be used to register congregate meal and transportation clients. Complete all applicable information below.

• HCCBG congregate nutrition (180), NSIP-only congregate meals (181), congregate liquid nutritional supplements(182) - complete Sections 1, 2, and 7 only.
• HCCBG general (250) or medical (033) transportation - complete sections 1 and 7 only.