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Serious Medical Procedure (SMR) Form - Care provider program staff
Serious Medical Procedure (SMR) Request Form
OMB: 0970-0561
IC ID: 244594
OMB.report
HHS/ACF
OMB 0970-0561
ICR 202311-0970-006
IC 244594
( )
Documents and Forms
Document Name
Document Type
Form 1
Serious Medical Procedure (SMR) Form - Care provider program staff
Form
1 Serious Medical Procedure (SMR) Request Form
SMR Form_Clean.docx
Form
Information Collection (IC) Details
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