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ODESSA/HCA BEHAVIORAL HEALTH CUSTOMER DATA CORE SECTION I Agency: Date of Transaction (MMDDYYYY): Member ID: Date of Birth (MMDDYYYY): Service Focus*: RACE: (1Yes for all that apply; Blank No) White
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CDC form basicfront is a form used to collect basic information regarding a certain topic.
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CDC form basicfront can be filled out by following the instructions provided on the form and entering the required information accurately.
The purpose of CDC form basicfront is to gather essential data for analysis or reporting purposes.
CDC form basicfront requires reporting of basic information such as name, contact details, and other relevant data.
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