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Get HI DHS 1149 Instructions 2013-2024

certifying the existence of a medical emergency that will not be treated without medical coverage. This form will assist the Med-QUEST Eligibility Worker (EW) in the determination of emergency processing for a medical application. The submission of this form does NOT guarantee eligibility. GENERAL INSTRUCTIONS: I. II. The form will be completed by a licensed physician A. The physician will certify that an emergent medical condition exists based on the diagnosis, the consequences of not recei.

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