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[PDF File]Form SSA-89 (02-2018) Discontinue Previous Editions Page 1 of ...
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Form SSA-89 (02-2018) Discontinue Previous Editions Social Security Administration. Page 1 of 2 OMB No.0960-0760. Authorization for the Social Security Administration (SSA)
[PDF File]The Mood Disorder Questionnaire (MDQ) - Overview
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The Mood Disorder Questionnaire (MDQ) - Overview The Mood Disorder Questionnaire (MDQ) was developed by a team of psychiatrists, researchers and consumer advocates to address the need for timely and accurate evaluation
[PDF File]TINETTI BALANCE ASSESSMENT TOOL
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TINETTI BALANCE ASSESSMENT TOOL GAIT SECTION Patient stands with therapist, walks across room (+/- aids), first at usual pace, then at rapid pace. Risk Indicators: Tinetti Tool Score Risk of Falls ≤18 High 19-23 Moderate ≥24 Low Date Indication of gait (Immediately after told to ‘go’.) Any hesitancy or multiple attempts = 0 No hesitancy = 1
[PDF File]INSTRUCTIONS: PERSONNEL REPORT
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SPECIFY DAYS AND HOURS ON DUTY DAYS FROM TO SPECIFY DAYS AND HOURS ON DUTY DAYS FROM TO SPECIFY DAYS AND HOURS ON DUTY DAYS FROM TO NAME B. STAFF EXEMPT FROM CRIMINAL BACKGROUND CHECK REQUIREMENTS:The following are believed exempt from criminal background check requirements pursuant to Sections 1522, 1568.09,
[PDF File]STOP-BANG Sleep Apnea Questionnaire
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STOP-BANG Sleep Apnea Questionnaire Chung F et al Anesthesiology 2008 and BJA 2012 STOP Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)? Yes No Do you often feel TIRED, fatigued, or sleepy during daytime? Yes No Has anyone OBSERVED you stop breathing during your sleep? Yes No
[PDF File]Pneumococcal Vaccine Timing for Adults
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do not repeat the dose. One dose of PCV13 is recommended for adults: 65 years or older who have not previously received PCV13. 19 years or older with certain medical conditions and who have not previously received PCV13. See Table 1 for specific guidance. One dose of PPSV23 is recommended for adults:
[PDF File]IRS 8300 Report of Cash Payments Over $10,000 FinCEN 8300 ...
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IRS Form 8300 (Rev. August 2014) Department of the Treasury Internal Revenue Service . Report of Cash Payments Over $10,000 Received in a Trade or Business
[PDF File]English 2019 California Driver Handbook
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handbook as well as practice exams, frequently asked questions and other material to educate and enhance your driving ability. Because no matter if you’re a veteran driver or a novice, we all benefit from good driving habits. Wishing you safe journeys, – i –
[PDF File]Form W-9 (Rev. October 2018)
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foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. participating foreign financial institution to report all United States 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a
[PDF File]Edinburgh Postnatal Depression Scale (EPDS)
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As you are pregnant or have recently had a baby, we would like to know how you are feeling. Please check the answer that comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today. Here is an example, already completed. I have felt happy: Yes, all the time
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