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(6) Preferred Provider Selection PCP/NPI # (from the enclosed Provider Directory) OFFICE USE ONLY Date Received: Rep Code: Agent Number: Group Number: Agency Number: Name of Provider (recommended)
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How to fill out enrollment application - ARMs:

01
Begin by collecting all necessary personal information such as your full name, date of birth, and contact details.
02
Provide your current address and any previous addresses if applicable.
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Fill in your educational background, including the name of schools attended, dates of attendance, and any degrees or certifications obtained.
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Indicate your employment history, including the names of previous employers, job titles, dates of employment, and a brief description of your responsibilities.
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Include any relevant professional licenses or certifications you hold.
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If required, provide information about your military service, including dates of enlistment, branch of service, and any relevant specialized training.
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Mention any relevant volunteer work or community involvement you would like to highlight.
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If applicable, disclose any criminal history or convictions transparently and accurately.
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Sign and date the application form to certify the accuracy of the information provided.

Who needs enrollment application - ARMs?

01
Individuals who are interested in enrolling in an Adult Residential Management (ARMs) program need to complete an enrollment application.
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People seeking a career in adult residential care management can benefit from enrolling in an ARMs program.
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Professionals working in the healthcare or social services industry who want to enhance their skills and knowledge in adult residential management may need to complete an enrollment application for an ARMs program.
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Enrollment application - arms is a form used to register individuals into a specific program or system.
Any individual who wants to participate or be a part of the program must file an enrollment application - arms.
The enrollment application - arms can usually be filled out online or in person by providing necessary personal information and following the instructions provided.
The purpose of the enrollment application - arms is to gather necessary information about individuals who wish to be involved in the program.
The enrollment application - arms typically requires information such as name, contact information, relevant background information, and any other details required by the program.
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