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[DOC File]MOTOR VEHICLE TRIP TICKET - Edward Hines, Jr. VA Hospital
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MOTOR VEHICLE TRIP TICKET U.S. GOV’T TAG NO.PART III. ( For use of Dispatcher, Driver, and User (Continued) PART I. ( For Use of Requesting and Approving Offices SERVICES AND SUPPLIES PROCURED FROM COMMERCIAL FACILITIES REQUESTED BY (Organization or individual) USER’S NAME (Print or type) COST Rehabilitation Research ITEM UNIT QUANTITY ...
[DOC File]SWORN STATEMENT
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SWORN STATEMENT. For use of this form, see AR 190-45; the proponent of this form is ODCSOPS. PRIVACY ACT STATEMENT. AUTHORITY: Title 10 USC Section 301; Title 5 USC Section 2951; E.O. 9397Dated November 22, 1943 (SSN) PRINCIPAL PURPOSE: To provide commanders and law enforcement officials with means by which information may be accurately ...
[DOCX File]Background Information Disclosure (BID) Appendix, F-82069
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DEPARTMENT OF HEALTH SERVICES. Division of Quality Assurance. F-82069 (06/2018) STATE OF WISCONSIN. Wis. Stat. § 50.065. Page 1 of 3. BACKGROUND INFORMATION DISCLOSURE (BID) APPENDIX
[DOC File]SUICIDE RISK ASSESSMENT GUIDE - Mental Health Home
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REFERENCE MANUAL. INTRODUCTION. The Suicide Risk Assessment Pocket Card was developed to assist clinicians in all areas but especially in primary care and the emergency room/triage area to make an assessment and care decisions regarding patients who present with suicidal ideation or provide reason to believe that there is cause for concern.
[DOC File]Data Assessment Plan (DAP) Note - HIV Prevention HPCPSDI
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Data Assessment Plan (DAP) Note. CLIENT/ID: Date: Counselor’s Initials: A DAP note is to be filled out each time you meet with a client for a CLEAR session. Please use the questions and statements listed below each section as a guide to what information needs to be included in order to ensure that this note is a complete explanation of the ...
[DOC File]files.dcs.tn.gov
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Tennessee Department of Children’s Services. Database Search Results. This form is to be used to request a search of the DCS current child welfare information system database.
[DOC File]Emergency Action Plan (Template)
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Title: Emergency Action Plan (Template) Author: Lewis N. Payton Last modified by: uzc9 Created Date: 8/8/2001 3:08:00 PM Company: Auburn University
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