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RCEB VENDOR SPECIAL INCIDENT REPORT Consumers Name Date of Birth UCI Number M Diagnosis Primary and secondary diagnoses (e.g. autism, mild mental retardation, seizure disorder, borderline personality.

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  4. Go to the e-autograph solution to e-sign the template.
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  6. Double-check the entire document to make sure you have not skipped anything important.
  7. Hit Done and save the resulting document.

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