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CONFIDENTIAL PATIENT INFORMATION First Name: SS#:Last Name: DOB:Marital Status:/Date: /Sex:# of Children://MFOccupation:Street Address:Height: Zip:City:State:Email:Cell Phone:Emergency Contact:Emergency

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Start by identifying the factors contributing to the situation worsening.

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Anyone facing a situation that is deteriorating and needs to take corrective action to prevent further decline.

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What is getting worse?

The situation is getting worse due to increasing pollution levels.

Who is required to file getting worse?

All businesses are required to file getting worse.

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What is the purpose of getting worse?

The purpose of getting worse is to assess the negative impact of the current situation.

What information must be reported on getting worse?

Information on the trends of the declining situation and the factors contributing to it must be reported on getting worse.

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