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Get Iowa Dhs Form 470 4698 2016

By faxing or mailing Form 470-4698 Critical Incident Report according to the directions on the form. 3. The Critical Incident Report Form 470-4698 consists of four distinct parts. Part 1 Initial Report must be completed and submitted by the end of the next calendar day following the incident. Iowa Department of Human Services Iowa Medicaid Enterprise Incident Management Provider Access System FORM 470-4698 CRITICAL INCIDENT REPORT USERS GUIDE Rev.

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