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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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Appeal form 08 revised is a form used to challenge a decision or action taken by a government agency.
Anyone who wishes to challenge a decision or action taken by a government agency must file 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.
The purpose of appeal form 08 revised is to allow individuals to challenge decisions or actions taken by government agencies.
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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