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Ambulatory Surgical Center Quality Reporting (ASCQR) Program Withdrawal of Participation Form
ICR 202601-0938-003 · OMB 0938-1270 · Object 165397000.
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Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Ambulatory Surgical Center Quality Reporting (ASCQR) Program Withdrawal of Participation Form |
| Subject | ASC Withdrawal of Participation Supplemental Document |
| Author | HSAG |
| File Created | 2026-01-14 |
| Conversion State | partial |