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PRINTED: 10/24/2019 FORM APPROVEDState of GA, Healthcare Facility Regulation Division STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:ALC000146(X2)
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Anyone who requires services or benefits provided by the Georgia Department of Community Health (DCH) may need to fill out forms available on the dch.georgia.gov website. This includes individuals seeking medical assistance, Medicaid applicants, healthcare providers, or anyone involved in healthcare programs administered by the DCH.
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The dchgeorgiagov forms of the Georgia department are the necessary forms for reporting certain information to the Georgia Department of Community Health.
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The purpose of the dchgeorgiagov forms of the Georgia department is to collect specific information needed by the Georgia Department of Community Health to regulate and monitor certain activities or entities within the state.
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The information that must be reported on the dchgeorgiagov forms of the Georgia department may vary depending on the specific form, but generally includes details about the individual or entity filing the form and the relevant data required by the Georgia Department of Community Health.
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