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HORIZON HEALTH APPLICATION FOR FINANCIAL ASSISTANCE How did you hear about our program? (family member, friend, Dr., etc)___ Applicants Name___DOB___ Applicants Address___Phone#___ Street/PO Box#CityStateZip

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How to fill out horizon health

01

Obtain a copy of the horizon health form.

02

Fill out your personal information including your name, date of birth, address, and contact information.

03

Provide information about your current health status and any medical conditions you may have.

04

Answer questions about your lifestyle and any habits that may affect your health.

05

Make sure to sign and date the form before submitting it.

Who needs horizon health?

01

Anyone who is seeking healthcare services from Horizon health organization.

02

Individuals who want to provide accurate information about their health for medical purposes.

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What is horizon health?

Horizon health refers to a program designed to improve healthcare outcomes and reduce costs through preventive care and wellness initiatives.

Who is required to file horizon health?

Employers with a certain number of employees are typically required to file horizon health.

How to fill out horizon health?

Horizon health forms can be filled out online or through paper forms provided by the employer.

What is the purpose of horizon health?

The purpose of horizon health is to promote a healthy lifestyle among employees and address health concerns before they become major issues.

What information must be reported on horizon health?

Information such as employee demographics, health screenings, and participation in wellness programs must be reported on horizon health.

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