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Eligibility Extension Request Form Please submit this form with the appropriate fee to:AHIMA Attn: Certification Dept./Extensions Fax: 312.233.1413AHIMA ID Number: Type or print neatly. Exam: CCA
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What is eligibility extension request form?
The eligibility extension request form is a document that allows individuals to request an extension to meet eligibility requirements for a specific program or benefit.
Who is required to file eligibility extension request form?
Individuals who are unable to meet the eligibility requirements by the original deadline are required to file the eligibility extension request form.
How to fill out eligibility extension request form?
To fill out the eligibility extension request form, individuals must provide their personal information, reason for requesting an extension, and any supporting documentation.
What is the purpose of eligibility extension request form?
The purpose of the eligibility extension request form is to give individuals additional time to meet the eligibility requirements for a program or benefit.
What information must be reported on eligibility extension request form?
The eligibility extension request form must include personal information, reason for requesting an extension, and any supporting documentation.
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