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FORM ORT1 REVISED 03/2014 THIS REPORT IS DUE ON OR BEFORE APRIL 15, 2014, STATE HEALTH PLANNING AND DEVELOPMENT AGENCY MAILING ADDRESS (U.S. Postal Service) STREET ADDRESS (Commercial Carrier) PO
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Page 1 state health is a form used to report health information to the state.
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Employers are required to file page 1 state health for their employees.
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