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Sample Homemaker/Personal Care Documentation Sheet OAC 5123:2930(E) (Designed for an Independent Provider by DODD 1/1/2014) Name of provider (6): Name of Individual .

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  1. Open the document in our feature-rich online editor by clicking Get form.
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  4. Use the e-autograph tool to add an electronic signature to the form.
  5. Add the relevant date.
  6. Double-check the whole document to make sure you have not skipped anything important.
  7. Click Done and download your new form.

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