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Patient and Family Advisory Council for Quality and Safety (PFA CQS) Questionnaire Applicant Information Name: Email address: Phone: Mailing address: City: State: ZIP Code: Please tell us about your
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Have you ever been is a form required by certain organizations to disclose any past criminal history or activities.
Individuals applying for jobs, licenses, or memberships may be required to fill out a have you ever been form.
You must provide accurate information about any past criminal history or activities in the designated sections of the form.
The purpose is to ensure transparency and help organizations make informed decisions about an individual's background.
Information such as arrests, convictions, and any other criminal activities must be reported on the form.
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