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Referral Form Dayton Interventional Radiology 3075 Governor s Place Blvd. Suite 120 Dayton, OH 45409 Phone: (937)424-2580 Date: ...

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What is one amp only referral?

One AMP Only referral is a process in which a single referral is made to the Asset Management Program (AMP) for assistance with managing a specific asset.

Who is required to file one amp only referral?

Any party that is seeking assistance in managing a specific asset can file a One AMP Only referral.

How to fill out one amp only referral?

One can fill out a One AMP Only referral by providing all relevant information about the asset in need of management assistance.

What is the purpose of one amp only referral?

The purpose of a One AMP Only referral is to seek assistance from the Asset Management Program in managing a specific asset.

What information must be reported on one amp only referral?

Information such as the type of asset, current condition, and assistance needed must be reported on a One AMP Only referral.

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