Dhs1149 instructions form 2025

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The DHS 1149 form is a Request for Application Emergency Processing that must be completed by a licensed physician to certify the existence of a medical emergency requiring immediate treatment. This form aids Med-QUEST Eligibility Workers in determining expedited processing for medical applications, although submission does not guarantee eligibility. The document outlines the responsibilities of physicians and eligibility workers in completing and reviewing the form to ensure timely processing of medical assistance applications.

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