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GWEM1 7/17REQUEST FOR PRIOR AUTHORIZATION FOR HOME MODIFICATIONS AND/OR SPECIAL MEDICAL EQUIPMENT/REHAB EQUIPMENT MID: Date of Assessment: Name: Address: DOB: Weight: Height: Physicians Name/RNA:
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What is mid date of assessment?
The mid date of assessment is the date halfway through a specific assessment period.
Who is required to file mid date of assessment?
Any individual or entity who is required to submit an assessment report is also required to file mid date of assessment.
How to fill out mid date of assessment?
The mid date of assessment can be filled out by entering the relevant information and submitting it by the deadline.
What is the purpose of mid date of assessment?
The purpose of mid date of assessment is to provide a progress update on the assessment process halfway through the assessment period.
What information must be reported on mid date of assessment?
The mid date of assessment typically requires reporting on the progress made in the assessment process, any challenges faced, and any adjustments to the assessment plan.
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