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Get IA Form 475-0409 2007

YED. SUBMIT WITH APPLICATION A CERTIFIED COPY OF YOUR HONORABLE DISCHARGE OR DD-214. A COPY OF A COMPLETE HISTORY AND PHYSICAL IS REQUIRED. THIS HISTORY AND PHYSICAL MUST BE DATED WITHIN THREE MONTHS FROM THE DATE THE IVH APPLICATION IS RECEIVED. YOUR HEALTH CARE PROVIDER MUST ALSO SUBMIT LAB WORK, IMMUNIZATIONS, YOUR HISTORY OF TESTING AND RESULTS OF RESISTANT ORGANISIMS (MRSA OR VRE), AND PPD (TB TESTING). CONTACT IVH AT 641-753-4325 OR COUNTY COMMISSION OFFICE IF A HISTORY AND PHYSICAL FORM I.

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