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Get Dominion Form SMCC 2011

with a serious medical condition may require administration of specialized treatments and may be dependent on medical technology such as ventilators, dialysis machines, enteral or parenteral nutrition support, or continuous oxygen. To extend the note, have your doctor complete and return the Serious Medical Condition Certification Form to us within 10 days. We will notify you when the completed form is received and if you are eligible for the medical program. If your medical condition changes, .

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