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1. Start completing your hawaii dhs 1128 with a selection of major blank fields. Get all the required information and make sure nothing is forgotten!
2. Once your current task is complete, take the next step – fill out all of these fields - Indicate your treatment plan and, V Explain in detail your patients, Base your decision on medical, and DHS Rev with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!
Concerning Base your decision on medical and DHS Rev, be certain you double-check them in this section. These two are certainly the key ones in this page.
3. The following portion focuses on Your patients disability is, PERMANENT, AT LEAST MONTHS REEVALUATION, TEMPORARY TO, MOYR, PrintType Name of Licensed, Signature of Licensed Treating, Address, City, Zip Code, Phone No, Date, Name of Health Plan, Medical Provider No or NPI, and VII PATIENT ACKNOWLEDGEMENT - type in all these blanks.
4. To go forward, this part requires filling in a couple of blanks. Included in these are Case Name, Case No, Workers Name, Section Unit, Unit Address, Phone No, Fax No, and DHS Rev, which are essential to continuing with this form.
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