Get MA MADS-A 2010
Security or SSI/SSDI benefits? . . . . . . . . . . . . . . . . . . . . . . . yes If yes, did you see a doctor for an exam? Doctor’s name: Date of exam: _____/_____/_____ MADS-A (Rev. 03/10) 1 Please go to the next page. Part 1. Your health problems List and describe all your medical and mental health problems. If you are getting treatment for the problem, please tell us what kind of treatment. List your medical and/or mental health problems. Describe the symptoms or.
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