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Attachment to Non-Emergency Transportation Services Prior Approval Program (NETS PAP) Notice to Dialysis Centers NETS PAP STANDING ORDER REQUEST ALL BLANKS M MUST BE ACCURATELY COMPLETED. FORM SENT

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1. Individuals who are residents of Illinois and wish to apply for healthcare benefits or report changes in their healthcare coverage.
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3. Anyone seeking to provide information about their income, dependents, and healthcare expenses for the purpose of determining eligibility for healthcare assistance in Illinois.

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