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Alabama Medicaid Agency 501 Dexter Avenue P.O. Box 5624 Montgomery, Alabama 361035624 www.medicaid.alabama.gov email: almedicaid@medicaid.alabama.gov Telecommunication for the Deaf: 18002530799 3342425000

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The dissatisfaction of services 3fmrevdoc form must include details about the services received, the reason for dissatisfaction, contact information, and any supporting documentation.

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