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1 NAME first middle last name suffix e.g. Jr Sr III First name Middle name Last name Suffix HMIS Data RHY TLP PROJECT EXIT FORM Revised September 20 2016 3. 8 HIV/AIDS IF YES for HIV/AIDS Is the client currently receiving services/treatment for this condition independently 4. Answer No for sources that have been terminated even if they were received in the past. No Yes Type of health insurance Private Private - Employer Private - Individual Medicare Medicaid Medi-Cal State...
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