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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15014606/26/2018FORM

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Start by reading the instructions provided on the form

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Anyone who is visiting a specific location or event that requires pre-registration or notification

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What is form visit was for?

Form visit is used to record information about a visit.

Who is required to file form visit was for?

Anyone who conducts a visit must file form visit.

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Form visit can be filled out online or in person.

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The purpose of form visit is to document the details of the visit.

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Information such as date, time, location, and purpose of the visit must be reported on form visit.

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