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PRINTED: 10/16/2017 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Form investigation of complaint is a document used to officially report a complaint and request an investigation.
Any individual or organization who wishes to formally report a complaint and request an investigation is required to file form investigation of complaint.
Form investigation of complaint can be filled out by providing details of the complaint, relevant information, and contact information of the person filing the complaint.
The purpose of form investigation of complaint is to initiate an official investigation into a reported complaint and take necessary actions based on the findings.
Information such as details of the complaint, evidence supporting the complaint, and contact information of the person filing the complaint must be reported on form investigation of complaint.
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