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Get pa 1671 form 2016-2024

Viding a diagnosis is not sufficient. Without this documentation, the client will be determined ineligible for benefits. Medication Needed: List the medication(s) needed by the applicant/recipient that address his medical condition thus enabling him/her to be able to work. Explanation: Explain in detail what the consequences to the applicant/recipient would be if the medication(s) listed above were not available to him/her. Document in this section whether the medication is for a chronic con.

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