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PRINTED: 08/30/2019 FORM APPROVEDDivision of Health Service Regulation STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION A.
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A Caring Heart AFL (Application for Financial Assistance) is a form used to request financial support for individuals or families in need.
Individuals or families who are seeking financial assistance for healthcare, education, or basic living needs are required to file a Caring Heart AFL.
To fill out a Caring Heart AFL, applicants need to provide personal information, income details, a description of their needs, and supporting documentation.
The purpose of a Caring Heart AFL is to assess an applicant's eligibility for financial assistance programs and to provide necessary support to those in need.
The Caring Heart AFL requires reporting information such as personal identification details, income level, family size, and specific financial needs.
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