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Submit Fax Request To: Behavioral Health Program 5074316329 (Fax)MH TCM Eligibility Notification Form Type of RequestInstructions: 1. For Initial or Annual Notification for MH TCM, submit this form. 2.

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What is mh-tch eligibility notification form?

The mh-tch eligibility notification form is a form used to notify individuals of their eligibility for mh-tch services.

Who is required to file mh-tch eligibility notification form?

Individuals who are seeking mh-tch services are required to file the eligibility notification form.

How to fill out mh-tch eligibility notification form?

The form can be filled out by providing relevant information such as personal details, medical history, and reason for seeking mh-tch services.

What is the purpose of mh-tch eligibility notification form?

The purpose of the form is to assess an individual's eligibility for mh-tch services and provide necessary support.

What information must be reported on mh-tch eligibility notification form?

Information such as name, contact details, medical history, and reason for seeking mh-tch services must be reported on the form.

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