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This is an application to become a Qualified Provider or Qualified Hospital in order to determine Presumptive Eligibility. Each staff member requesting to process Presumptive Eligibility applications

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What is this is an application?

This is an application is a form or document that needs to be completed in order to apply for something, such as a job, school, or program.

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What is the purpose of this is an application?

The purpose of this is an application is to gather important information about the applicant in order to make a decision on their eligibility or suitability for whatever the application is for.

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The information required on this is an application typically includes personal details, contact information, educational background, work experience, and possibly references.

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