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LONG-TERM CARE HOME SERVICE ACCOUNTABILITY AGREEMENT For the Period: April 1, 2013, March 31, 2016, Index to Agreement ARTICLE TOPIC 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 11.0 12.0 13.0 14.0 15.0
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How to fill out acknowledgement of lhin support

How to fill out acknowledgement of LHIN support:
01
Start by entering your personal information, including your name, address, and contact details, in the designated fields on the form.
02
Identify the LHIN program or service that you have received support from and provide specific details about the support you have received. This may include the type of service, the dates of service, and any relevant case numbers or references.
03
If applicable, indicate the name of the healthcare provider or organization that provided the support and their contact information.
04
Sign and date the acknowledgement form to indicate your agreement and understanding of the support provided by the LHIN.
05
If there are any additional fields or sections on the form, fill them out as required based on the instructions provided.
06
Ensure that all the information provided is accurate and complete before submitting the acknowledgement form.
07
Make a copy of the completed form for your records, if necessary.
Who needs acknowledgement of LHIN support:
01
Individuals who have received support from a LHIN program or service may need to fill out an acknowledgement form.
02
This may include patients who have received home care services, mental health support, long-term care placement assistance, or any other type of support provided by the Local Health Integration Network (LHIN).
03
It is important to check with the specific LHIN or healthcare provider to determine if an acknowledgement form is required in your particular case.
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