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Get WI DHS F-00523 2012-2024

E rule language for application purposes. Applicants for a new outpatient service must demonstrate preparedness to comply with all Chapter DHS 75.03 standards. Applicants will have completed all required policies, including Chapter DHS 94 (Patient Rights). Use the check boxes ( ) to affirm readiness to meet standards. ATTENTION: The clinic must contact the regional Health Services Specialist to arrange a site visit following the submission of fee and this application. Chapter DHS 75.01(1) Autho.

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