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Application Submission Instructions Please complete the attached application and send to Health Plan One either via fax or mail: (must submit by mail if enclosing a check or money order) Health Plan

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1. Begin by reviewing the form in its entirety to understand the information and sections required.
2. Start by entering your personal details such as your name, address, contact information, and any other necessary identification details.
3. Carefully read each section of the form and provide the requested information accurately. This may include details about your employment, education, or other relevant background information.
4. If the form requires you to provide supporting documentation (e.g., photocopies of your identification, proof of address), ensure you attach these documents securely to the form.
5. Double-check all the information you have provided before submitting the form to ensure its accuracy and completeness.
6. Once you have filled out the form entirely, securely attach it to the relevant communication (e.g., email, letter) as instructed.
7. If you are unsure about any sections or have any questions related to the form, reach out to the appropriate person or organization for clarification.
8. Finally, keep a copy of the completed form and any related documentation for your records.

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