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ENROLLMENT AGREEMENTKnown nationally as the Program of AllInclusive Care for the Elderly (PACE)1TABLE OF CONTENTSWELCOME .. 4 NOTICE OF NONDISCRIMINATION . 5 MISSION STATEMENT . 5 PROGRAM FEATURES
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How to fill out cha pace enrollment agreement
How to fill out cha pace enrollment agreement
01
Gather all necessary information such as personal details, contact information, and medical history.
02
Read through the enrollment agreement carefully to understand all terms and conditions.
03
Fill out the agreement form accurately and truthfully.
04
Sign and date the agreement where required.
05
Submit the completed enrollment agreement to the appropriate CHA PACE representative.
Who needs cha pace enrollment agreement?
01
Individuals who are eligible and interested in enrolling in the CHA PACE program.
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What is cha pace enrollment agreement?
The cha pace enrollment agreement is a contract between a participant and the program outlining the terms and conditions of enrollment.
Who is required to file cha pace enrollment agreement?
Participants who wish to enroll in the program are required to file the cha pace enrollment agreement.
How to fill out cha pace enrollment agreement?
Participants must carefully read and fill out all sections of the cha pace enrollment agreement, providing accurate and complete information.
What is the purpose of cha pace enrollment agreement?
The purpose of the cha pace enrollment agreement is to establish the rights and responsibilities of both the participant and the program.
What information must be reported on cha pace enrollment agreement?
The cha pace enrollment agreement must include personal information of the participant, chosen plan, payment details, and other relevant information.
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