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This document is used for verifying completion of in-service training for support coordinators in Florida.
This form is used for reporting adverse incidents that occur in physician offices in the state of Florida. It helps ensure that patient safety is maintained and that any necessary investigations or interventions can be conducted.
This form is used for Osteopathic Physicians who are active duty military or veterans and want to apply for a temporary certificate to practice in areas of critical need in Florida.
This form is used for reinstatement in California for Group 2 compliance with MCLE (Minimum Continuing Legal Education).
This document is a personal log form used by Group 2 members of MCLE in California. It is used to track personal activities and record progress.
This form is used for obtaining Erythropoiesis Stimulating Agents (ESA) in the state of Florida.
This document is used for verifying HIV diagnoses or providing prophylaxis for HIV in the state of Florida.
This Form is used for applying for a Retailer's Liquor License in the state of Illinois.
This form is used for requesting a change in hours of operation for businesses located in Illinois. It is necessary when you want to modify the permitted working hours for your establishment.
This application is used in California to request restoration to active status before renewal.
This document is used to acknowledge the presence of guests in Hawaii.
This form is used for applying to the Medical Consultant Program in California.
This form is used for physicians in California who want to apply for a waiver from paying the initial license or renewal fee.
This form is used for applying for health insurance in California.
This form is used for applying for private health insurance in California. It is specifically designed for individuals who require large print materials.
This document is for individuals in California to file a complaint regarding bilingual services. It provides a formal way to address any issues or concerns with the provision of language assistance.
This form is used to request a state fair hearing in California to appeal a Covered California eligibility determination.
This form is used for notifying the California Health Benefit Exchange (HBEX) of the death of an individual by an estate representative.
This form is used for notifying the California Health Benefit Exchange (HBEX) about the death of an enrolled member. It is a way to inform the exchange about the change in the member's status.
This Form is used for filing complaints about bilingual services in California.
This form is used for filing a complaint for residential summary possession in Hawaii specifically for unpaid rent issues.
This form is used for applying for private health insurance in the state of California.
This Form is used for applying for certification of part-time library staff in the state of Kentucky.
This document is for reporting part-time certification learning activities in Kentucky.
This Form is used for requesting an extension of license privileges for an on-premises establishment in the state of Maine.
This form is used for applying for a license for an incorporated civic organization in the state of Maine.
This form is used for applying for an exemption for an incorporated nonprofit organization in Maine that provides certain services for persons who are hard of hearing.