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272M SR 07XX 08/07 NEW HAMPSHIRE MEDICAID MOBILITY EVALUATION From This evaluation must be completed by a New Hampshire licensed physician, occupational therapist, or physical therapist specializing
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What is mobility evaluation form?
The mobility evaluation form is a document used to assess an individual's physical mobility and functional abilities.
Who is required to file mobility evaluation form?
Individuals who are applying for certain benefits or services may be required to file a mobility evaluation form.
How to fill out mobility evaluation form?
The mobility evaluation form must be filled out accurately and completely, providing detailed information about the individual's mobility limitations.
What is the purpose of mobility evaluation form?
The purpose of the mobility evaluation form is to determine an individual's level of physical mobility and functional abilities in order to assess their eligibility for certain benefits or services.
What information must be reported on mobility evaluation form?
The mobility evaluation form typically requests information about the individual's medical history, mobility limitations, and any assistive devices or accommodations they use.
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