Dental Office Application With Medicaid In Allegheny
Category:
State:
Multi-State
County:
Allegheny
Control #:
US-00413-1
Format:
Word;
Rich Text
Instant download
Description
This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
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Download, fill out, and print a paper application then send it to your local County Assistance Office. Fill out this form. 2.Sign and date it on page 1 and page 15. 3. Need help applying for. MA? You just need to complete the application process and have your eligibility verified by. We accept Medicaid and many insurance plans. We also are happy to see you if you do not have any dental insurance. Accepts most third-party payments including state Medical Assistance plans and private insurance. Sliding scale fees are available for people without insurance. Download and print the AHN Financial Assistance Application.