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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15510309/07/2012FORM
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F0000 is a form that needs to be filled out during this visit.
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The purpose of f0000 is to document the details of the visit for record-keeping purposes.
Information such as date, time, location, participants, and purpose of the visit must be reported on f0000.
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