Get OK ODH Form 606 2001
E you willing, in the future to accept new patients? ___ Yes ___ No Do you admit your own patients to hospitals? If no, please explain how your patients will be admitted, which hospital and who will provide patient care. ___ Yes ___ No Are you willing to accept current patients if they convert to the healthcare plan to which you are applying? ___ Yes ___ No Are you a member of an Independent Practice Association or a Physician Hospital Association? If yes, complete the following: Name: Street A.
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