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NH Department of Health and Human Services (HHS) Division of Family Assistance (DFA) DFA Form 752HH 11/11 Rev 1/15 Physician/Clinician Statement of Necessary Patient Care for a Household Member PLEASE

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What is dfa form 752hh physician?

DFA Form 752HH Physician is a form used for reporting certain medical information.

Who is required to file dfa form 752hh physician?

Physicians and healthcare providers are required to file DFA Form 752HH Physician.

How to fill out dfa form 752hh physician?

DFA Form 752HH Physician can be filled out by providing accurate medical information as requested on the form.

What is the purpose of dfa form 752hh physician?

The purpose of DFA Form 752HH Physician is to collect and report medical information for regulatory purposes.

What information must be reported on dfa form 752hh physician?

Medical information such as diagnosis, treatment, and physician recommendations must be reported on DFA Form 752HH Physician.

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