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Appeal Form PO Box 30055
Durham, NC 277023055
State Health Plan PPO
Blue Advantageous Clearblue OptionsBlue ChoiceClassic Brother ___
PATIENT INFORMATIONAL
STREET ADDRESS
CITYSTATEHOME TELEPHONE NUMBERWORK
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What is appeal form 08 revised?
Appeal form 08 revised is a form used to challenge a decision or action taken by a government agency.
Who is required to file appeal form 08 revised?
Anyone who wishes to challenge a decision or action taken by a government agency must file appeal form 08 revised.
How to fill out appeal form 08 revised?
To fill out appeal form 08 revised, provide your personal information, the decision or action being challenged, and the reasons for the challenge.
What is the purpose of appeal form 08 revised?
The purpose of appeal form 08 revised is to allow individuals to challenge decisions or actions taken by government agencies.
What information must be reported on appeal form 08 revised?
The information that must be reported on appeal form 08 revised includes personal details, details of the decision or action being challenged, and the reasons for the challenge.
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