Shown below are the details for the item you selected from the list.
| Form # |
CMS 29 |
| Form Title |
REQUEST TO ESTABLISH ELIGIBILITY TO PARTICIPATE IN HI FOR AGED/DISABLED TO PROVIDE RURAL HEALTH CLINIC SERVICES |
| Revision Date |
05/01/1978 |
| O.M.B. # |
0938-0074 |
| O.M.B. Expiration Date |
01/31/2009 |
| CMS Manual |
N/A |
| Special Instructions |
N/A |
| | | Downloads |
CMS 29 (449 KB)
| | Related Links Inside CMS |
There are no Related Links Inside CMS
| | Related Links Outside CMS |  |
There are no Related Links Outside CMS
|
|
Last Modified Date : 01/08/2009
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