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C Illness or Injury To the applicant: Forward both parts of this form to your healthcare provider. PART I: TO BE COMPLETED BY EMPLOYEE 1. Employee s Name: (First, Middle Initial, Last) 2. Employee s Title: 3. Employee s Home Address:.

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You will need to recertify continuing medical needs every 90 days. Equipment not considered life sustaining: refrigerator, air conditioner, nebulizer, CPAP machine, wheelchairs or bed confinement.

"Life-sustaining equipment" means a medical product that is necessary for a consumer to avoid exposure to a medically reasonable expectation of imminent death or serious injury. The term includes, without limitation, a ventilator. The term does not include an oxygen concentrator.

The term service life includes the time of use that a device is intended to remain functional after it has been manufactured, put into service, and maintained as specified. Shelf life is the term or period during which a device or accessory remains suitable for the intended use, whether it is stored or used.

Life-support equipment includes respirators (oxygen concentrators), iron lungs, hemodialysis machines, suction machines, electric nerve stimulators, pressure pads and pumps, aerosol tents, electrostatic and ultrasonic nebulizers, compressors, intermittent positive pressure breathing (IPPB) machines, and motorized ...

Normally, average useful life of any medical equipment is expected to be between 5-7 years. However, if well-maintained, medical equipment may continue to be used for a longer time, say another 5 years. Beyond that, medical equipment is highly likely to be technologically obsolete and difficult to support.

You will need to recertify continuing medical needs every 90 days. Equipment not considered life sustaining: refrigerator, air conditioner, nebulizer, CPAP machine, wheelchairs or bed confinement.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232