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CLINIC APPLICATION: 20182019 NAME: ___EXPECTED GRAD. DATE:___EMAIL: ___@___PHONE #: ___ PLEASE LIST ALL COURSES COMPLETED RELEVANT TO THIS AREA (E.G., ADMINISTRATIVE LAW, HEALTH CARE LAW, TORTS, TRIAL

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How to fill out uniform application - dpbh

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Step 1: Gather all necessary information such as personal details, contact information, and relevant health history.

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Step 2: Start by filling out the basic information section including name, date of birth, and address.

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Step 3: Proceed to answer the health-related questions honestly and accurately.

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Step 4: Review the completed application form to ensure all sections are filled out correctly.

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Step 5: Submit the filled out uniform application to the designated organization or healthcare provider.

Who needs uniform application - dpbh?

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Individuals seeking behavioral health services from the Department of Public and Behavioral Health (DPBH) are required to fill out the uniform application.

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