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Fax, Mail or Email Completed Form to SCYAP Admissions Sara Beth Mefford Email: referral@scyap.com140 Stoneridge Drive, Suite 350 Columbia, SC 29210 Phone: (803) 7795500 Fax: (803) 2741330Click to Send Completed FormSouth Carolina Youth Advocate Program CommunityBased Services Referral Form (Please complete to the best of your ability)*Date of Referral:Client Information*Name:Select Health Blue Choice*Medicaid #:DOB:Gender:Molina Absolute Total Care HumanaRace:Legal
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Fax mail or e-mail refers to the transmission of documents and information through telecommunication systems, either using a fax machine or via electronic mail (e-mail).
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