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Description of medical status
Office of Aging and Adult Services OAAS STATEMENT OF MEDICAL STATUS SMS For Home and Community Base Services HCBS Programs Use Only The purpose of this form is to verify medical information reported by the patient for home and community-based services. Total number of minutes provided in the last 7 days Therapy Speech Therapy Occupational Therapy Physical Therapy E. Physician s Name type or print Address Signature...
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medical status
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