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Get Form Sma 168 Printable

INSTRUCTIONS FOR EXCEPTION REQUEST AND RECORD OF JUSTIFICATION UNDER 42 CFR 8. 11 h FORM SMA-168 Purpose of Form The SMA-168 form was created to facilitate the submission and review of patient exceptions under 42 CFR 8. The OMB control number for this project is 0930-xxxx. SMA-168 INSTRUCTIONS BA DEPARTMENT OF HEALTH AND HUMAN SERVICES SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION CENTER FOR SUBSTANCE ABUSE TREATMENT Exception Request.

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