Form OMHA-100 Request for Administrative Law Judge (Alj) Hearing or Review of Dismissal

Form OMHA-100 Request for Administrative Law Judge (Alj) Hearing or Review of Dismissal

What Is Form OMHA-100?

This is a legal form that was released by the U.S. Department of Health and Human Services on July 1, 2020 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2020;
  • The latest available edition released by the U.S. Department of Health and Human Services;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OMHA-100 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services.

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Download Form OMHA-100 Request for Administrative Law Judge (Alj) Hearing or Review of Dismissal

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