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DEPARTMENT OF HEALTH SERVICES Division of Long Term Reinstate OF WISCONSINF01812 (9/2016)WISCONSIN MEDICAID PROGRAM 2016 NURSING HOME COST REPORT Completion of this form is required by Section 1.171

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How to fill out shawano health services

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Gather all necessary personal information such as name, date of birth, address, and contact information.

02

Complete the health services form either online or in person at the Shawano Health Services office.

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Provide information about your medical history, current health concerns, and any medications you are currently taking.

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Follow up with any additional documentation or appointments as requested by the health services team.

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Individuals who require medical care or assistance with managing their health conditions.

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What is shawano health services?

Shawano Health Services is a healthcare provider located in Shawano, Wisconsin offering medical services to the community.

Who is required to file shawano health services?

Patients who receive medical services from Shawano Health Services are required to provide their personal and insurance information for filing purposes.

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To fill out Shawano Health Services forms, individuals need to provide accurate personal information, insurance details, and medical history.

What is the purpose of shawano health services?

The purpose of Shawano Health Services is to provide quality healthcare services to individuals in the Shawano community.

What information must be reported on shawano health services?

Information such as personal details, insurance information, medical history, and current health concerns must be reported on Shawano Health Services forms.

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