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Partners Behavioral Health Management Serving Burke Catawba Cleveland Gaston Iredell Lincoln Surry and Yadkin Counties NC Division of MH/DD/SAS NC INNOVATIONS MEDICAL ASSESSMENT Individual s Name Waiver I. System Disorder/Name of Condition Circle One a. Respiratory Yes b. Cardiovascular c. Gastro-Intestinal d. Mobility ambulatory semi-ambulatory non-ambulatory 5. self-direction managing one s social and personal life and have the ability to make decisions necessary to protect one s self 6....
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