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Get the free WV-BMS-CSED-12 Request to Continue Services Effective March 1 ... - dhhr wv

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WEST VIRGINIA CHILDREN WITH SERIOUS EMOTIONAL DISORDER (USED) WAIVER REQUEST TO CONTINUE SERVICES Date Submitted: Provider Agency: Agency Location (if applicable): Name of person submitting request:
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The wv-bms-csed-12 request to continue is a form used to request an extension or continuation of services under the West Virginia Bureau for Medical Services.
Individuals who are currently receiving services through the West Virginia Bureau for Medical Services and wish to continue those services are required to file the wv-bms-csed-12 request to continue.
To fill out the wv-bms-csed-12 request to continue, provide your personal information, service details, and any necessary documentation supporting your request.
The purpose of the wv-bms-csed-12 request to continue is to ensure that eligible individuals can maintain their access to necessary medical and support services without interruption.
Information that must be reported includes personal identification details, the dates of current services, and any changes in circumstances that could affect eligibility.
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