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PHYSICIANS REPORT-CHILD CARE CENTERS
I hereby authorize release of medical information contained in this report to the above-named Child Care Center. (SIGNATURE OF PARENT, GUARDIAN, OR CHILDS
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Medicare
Form CMS-2552-10, which contains instructions for the completion of the new cost report forms to be filed by hospitals and hospital health care complexes.
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Contra Costa Mental Health Plan (CCMHP) Triennial
Jun 1, 2021 Contra Costa Mental Health Implementation Plan March 2019 schedule to offer and, or complete an initial clinical assessment appointment.
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