Serious Medical Procedure (SMR) Request Form

OMB 0970-0561

Latest Forms, Documents, and Supporting Material

Document Name
Form 1 Serious Medical Procedure (SMR) Form - Care provider program staff Form
Form 1 Serious Medical Procedure (SMR) Form - Pediatric surgeons Form
Attachment A_Flores Agreement.docx Supplementary Document
Supporting Statement A_SMR Form_cln_KB.docx Supporting Statement A
Serious Medical Procedure (SMR) Form - Care provider program staff Form
Serious Medical Procedure (SMR) Form - Pediatric surgeons Form