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Form Approved OMB No. 0920-0891 Exp. Date 12/31/2014 SSM World Trade Center Health Program Responder Eligibility Application (Other than FD NY) A World Trade Center (WTC) Health Program General Responder
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How to fill out world trade center health

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How to fill out World Trade Center Health:

01
Gather all necessary information and documentation such as medical records, proof of presence at the World Trade Center site, and any supporting documents related to health conditions.
02
Download or obtain the appropriate enrollment form for the World Trade Center Health Program.
03
Carefully review the instructions provided with the enrollment form to ensure you understand the requirements and eligibility criteria.
04
Fill in all requested personal information accurately, including contact details, social security number, and any additional information required.
05
Provide details about your exposure to the World Trade Center site, such as dates and duration of presence, specific areas visited, and any incidents or events related to your exposure.
06
Disclose any relevant medical conditions or symptoms that you believe may be linked to your exposure at the World Trade Center site.
07
Attach any supporting documentation, such as medical records or letters from healthcare providers, that validate your eligibility or provide further information about your health conditions.
08
Review the completed form to ensure all sections are filled out correctly and all necessary attachments are included.
09
Submit the filled-out enrollment form and any supporting documents to the appropriate address or online portal as instructed in the enrollment instructions.

Who needs World Trade Center Health:

01
Individuals who were present in the vicinity of the World Trade Center, including the site itself, during and after the September 11, 2001 terrorist attacks.
02
Responders, such as firefighters, police officers, and emergency medical personnel who participated in the rescue, recovery, and cleanup efforts at the World Trade Center site.
03
Survivors who lived, worked, or attended school in the neighborhoods near the World Trade Center site in the months following the attacks.
04
Individuals who were present in the Pentagon or Shanksville, Pennsylvania during the September 11, 2001 attacks, and were involved in the rescue, recovery, and cleanup efforts.
05
Family members of deceased individuals who were eligible for the World Trade Center Health Program benefits.
It is important to note that eligibility criteria and requirements may vary, so individuals are encouraged to consult the official World Trade Center Health Program website or consult with program administrators for exact details pertaining to their specific situation.
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World Trade Center Health is a program that provides medical monitoring and treatment for first responders, recovery workers, and survivors of the September 11, 2001 terrorist attacks.
Those eligible for the World Trade Center Health program are required to file for benefits.
To fill out World Trade Center Health forms, individuals can contact the program directly or visit their website for more information.
The purpose of World Trade Center Health is to ensure that those affected by the 9/11 attacks have access to medical monitoring and treatment.
Information such as medical history, exposure to toxins at Ground Zero, and current health status may need to be reported on World Trade Center Health forms.
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