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Get the free Your name has been released from both the Medically Dependent Children Program (MDCP...

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If the individual receives SSI or is already enrolled in Medicaid you do not need to complete this form. Form 0003 Authorization to Furnish Information. This form must be completed and returned if you want to apply for MDCP services. An individual can be enrolled in only one waiver program at a time so you must make a choice between MDCP and CLASS. Information is enclosed to assist you in making a program selection that best meets your needs. Form 2439 Application Acknowledgement. This form...
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