DD Form 2948 Special Compensation for Assistance With Activities of Daily Living (SCAADL) Eligibility

What Is DD Form 2948?

DD Form 2948, Special Compensation for Assistance with Activities of Daily Living (SCAADL) Eligibility is a form used to determine a service member's eligibility to receive SCAADL as a result of an injury or illness received in the line of duty.

The form - sometimes incorrectly referred to as the DA Form 2894 - was last revised by the Department of Defense (DoD) in August 2015 with all previous editions being obsolete. An updated DD Form 2894 fillable version is available for digital filing and download through the link below.

Special Compensation for Assistance with Activities of Daily Living - or SCAADL - is a monthly payment for service members who require caregiver support due to a medical condition. The program is designed to reimburse its participants for non-medical care and support expenses. The payments are based on the level of the support required and the location of the service member.

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SPECIAL COMPENSATION FOR ASSISTANCE WITH ACTIVITIES OF DAILY LIVING (SCAADL) ELIGIBILITY
(Read DoD Instruction (DoDI) 1341.12,“Special Compensation for Assistance with Activities of Daily Living Program," DoD Manual (DoDM) 1341.12,
“Special Compensation for Assistance with Activities of Daily Living Process,” and the attached Instructions before completing this form.)
PRIVACY ACT STATEMENT
AUTHORITY: 37 U.S.C. Section 439; DoDD 5154.02; DoDI 1341.12, and E.O. 9397 (SSN), as amended.
PRINCIPAL PURPOSE(S): To allow a Service member to request SCAADL. To allow a DoD or VA licensed physician to certify or recertify
that the applicant has a permanent catastrophic injury or illness that was incurred or aggravated in the line of duty and needs assistance from
another person to perform personal functions required in everyday living or requires constant supervision and in the absence of the provision of
such care would require hospitalization, nursing home, or other residential institutional care. To allow the Services to provide detailed monthly
listings of individuals with such determinations to the Defense Finance and Accounting Service of the effective start and stop date of payments for
special compensation for assistance with activities of daily living. To allow Commander or Service Designated Representative and DoD or VA
licensed physician to determine the eligibility of the Service member to receive SCAADL.
ROUTINE USE(S): The DoD "Blanket Routine Uses" found at http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx apply to
this collection.
DISCLOSURE: Voluntary. However, failure to provide requested information may result in a denial or delay in processing your request for
special compensation for assistance with activities of daily living.
DEFINITIONS
Designated Representative: A person designated to make SCAADL decisions for the Service member. This could be a person designated by the
Service member, a court-appointed guardian, or a personal representative in accordance with DoD 6025.18-R.
DoD or VA Licensed Physician: A physician (excludes contractor physicians) with medical expertise in the determination of medical disability by
nature of their medical specialty training, or completion of training specifically with the intent and requirements of SCAADL evaluation and
certification.
Health Care Professional: Military (Active Duty/Reserve/National Guard) and civilian (GS and those working under contractual or similar
arrangement) personnel who have received advanced education or training beyond the technical level in a recognized health care discipline and
who are licensed, certified, or registered by a State, Government agency, or professional organization to provide specific health services in that
field. This includes those involved in the provision of diagnostic, therapeutic, or preventive care, ancillary services, and administration.
Service Designated Representative: An individual authorized to certify a Service member's SCAADL eligibility on the DD Form 2948 on behalf
of the respective Military Service.
ELIGIBILITY
For the Service member to be eligible for SCAADL, DoD policy requires that the person meet all four of the following conditions:
(1) has a permanent catastrophic injury or illness that was incurred or aggravated in the line of duty;
(2) has been certified by a DoD or VA licensed physician to be in need of assistance from another person to perform personal functions required in
everyday living;
(3) in the absence of the provision of such assistance, would require hospitalization, nursing home care, or other residential institutional care; and
(4) meets such other criteria, if any, as the Secretary of Defense prescribes for purposes of this section.
PRESCRIBING DOCUMENTS
In accordance with DoDI 1341.12 and DoDM 1341.12, the following information is required to determine the qualification, compensation, and to
recertify eligibility for the referenced Service member.
1. TYPE OF REQUEST:
INITIAL APPLICATION
RECERTIFICATION
APPELLATE REVIEW
PART I - ELIGIBILITY CRITERIA
(The Service member is not eligible for SCAADL if any question in Section 6 is answered "No".)
2. SERVICE MEMBER NAME (Last, First, MI)
3. CURRENT PAY GRADE
5. DATE OF BIRTH
4. SSN (Last 4 digits)
(MM/DD/YYYY)
(e.g., O1 - O9; E1 - E9)
6. DoD OR VA LICENSED PHYSICIAN - CERTIFYING PART I (Select Yes or No to each question.)
By signing this form, I certify that (1) the Service member would require hospitalization, nursing home care, or residential institutional care in the
absence of assistance with any activities of daily living (ADLs), (2) I understand the intent of SCAADL, and (3) I have read the DoDI 1341.12 and
DoDM 1341.12.
YES
NO
a. Service member has a permanent catastrophic injury or illness (per DoDI 1341.12 and DoDM 1341.12).
b. Service member needs assistance from another person to perform the personal functions required in everyday living or
requires constant supervision.
c. Service member, in the absence of assistance from another person, would require hospitalization, nursing home care, or other
residential institutional care.
d. Service member is an outpatient and has a designated primary caregiver.
e. Service member
is eligible for SCAADL
- OR -
is not eligible for SCAADL. (Certifying blocks 6.a., b., c., and d.)
f. PRINTED NAME
g. CONTACT INFORMATION
(Last, First, MI)
(Email and/or telephone)
h. SIGNATURE
i. DATE SIGNED
(MM/DD/YYYY)
The Service member is not eligible for SCAADL if any question in Section 6 is answered "No". IF THE SERVICE MEMBER IS NOT ELIGIBLE
FOR SCAADL BASED ON THE REQUIREMENTS IN SECTION 6, PROCEED TO SECTIONS 16 AND 17.
DD FORM 2948, AUG 2015
Page 1 of 8 Pages
PREVIOUS EDITION IS OBSOLETE.
Adobe Designer 9.0
SPECIAL COMPENSATION FOR ASSISTANCE WITH ACTIVITIES OF DAILY LIVING (SCAADL) ELIGIBILITY
(Read DoD Instruction (DoDI) 1341.12,“Special Compensation for Assistance with Activities of Daily Living Program," DoD Manual (DoDM) 1341.12,
“Special Compensation for Assistance with Activities of Daily Living Process,” and the attached Instructions before completing this form.)
PRIVACY ACT STATEMENT
AUTHORITY: 37 U.S.C. Section 439; DoDD 5154.02; DoDI 1341.12, and E.O. 9397 (SSN), as amended.
PRINCIPAL PURPOSE(S): To allow a Service member to request SCAADL. To allow a DoD or VA licensed physician to certify or recertify
that the applicant has a permanent catastrophic injury or illness that was incurred or aggravated in the line of duty and needs assistance from
another person to perform personal functions required in everyday living or requires constant supervision and in the absence of the provision of
such care would require hospitalization, nursing home, or other residential institutional care. To allow the Services to provide detailed monthly
listings of individuals with such determinations to the Defense Finance and Accounting Service of the effective start and stop date of payments for
special compensation for assistance with activities of daily living. To allow Commander or Service Designated Representative and DoD or VA
licensed physician to determine the eligibility of the Service member to receive SCAADL.
ROUTINE USE(S): The DoD "Blanket Routine Uses" found at http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx apply to
this collection.
DISCLOSURE: Voluntary. However, failure to provide requested information may result in a denial or delay in processing your request for
special compensation for assistance with activities of daily living.
DEFINITIONS
Designated Representative: A person designated to make SCAADL decisions for the Service member. This could be a person designated by the
Service member, a court-appointed guardian, or a personal representative in accordance with DoD 6025.18-R.
DoD or VA Licensed Physician: A physician (excludes contractor physicians) with medical expertise in the determination of medical disability by
nature of their medical specialty training, or completion of training specifically with the intent and requirements of SCAADL evaluation and
certification.
Health Care Professional: Military (Active Duty/Reserve/National Guard) and civilian (GS and those working under contractual or similar
arrangement) personnel who have received advanced education or training beyond the technical level in a recognized health care discipline and
who are licensed, certified, or registered by a State, Government agency, or professional organization to provide specific health services in that
field. This includes those involved in the provision of diagnostic, therapeutic, or preventive care, ancillary services, and administration.
Service Designated Representative: An individual authorized to certify a Service member's SCAADL eligibility on the DD Form 2948 on behalf
of the respective Military Service.
ELIGIBILITY
For the Service member to be eligible for SCAADL, DoD policy requires that the person meet all four of the following conditions:
(1) has a permanent catastrophic injury or illness that was incurred or aggravated in the line of duty;
(2) has been certified by a DoD or VA licensed physician to be in need of assistance from another person to perform personal functions required in
everyday living;
(3) in the absence of the provision of such assistance, would require hospitalization, nursing home care, or other residential institutional care; and
(4) meets such other criteria, if any, as the Secretary of Defense prescribes for purposes of this section.
PRESCRIBING DOCUMENTS
In accordance with DoDI 1341.12 and DoDM 1341.12, the following information is required to determine the qualification, compensation, and to
recertify eligibility for the referenced Service member.
1. TYPE OF REQUEST:
INITIAL APPLICATION
RECERTIFICATION
APPELLATE REVIEW
PART I - ELIGIBILITY CRITERIA
(The Service member is not eligible for SCAADL if any question in Section 6 is answered "No".)
2. SERVICE MEMBER NAME (Last, First, MI)
3. CURRENT PAY GRADE
5. DATE OF BIRTH
4. SSN (Last 4 digits)
(MM/DD/YYYY)
(e.g., O1 - O9; E1 - E9)
6. DoD OR VA LICENSED PHYSICIAN - CERTIFYING PART I (Select Yes or No to each question.)
By signing this form, I certify that (1) the Service member would require hospitalization, nursing home care, or residential institutional care in the
absence of assistance with any activities of daily living (ADLs), (2) I understand the intent of SCAADL, and (3) I have read the DoDI 1341.12 and
DoDM 1341.12.
YES
NO
a. Service member has a permanent catastrophic injury or illness (per DoDI 1341.12 and DoDM 1341.12).
b. Service member needs assistance from another person to perform the personal functions required in everyday living or
requires constant supervision.
c. Service member, in the absence of assistance from another person, would require hospitalization, nursing home care, or other
residential institutional care.
d. Service member is an outpatient and has a designated primary caregiver.
e. Service member
is eligible for SCAADL
- OR -
is not eligible for SCAADL. (Certifying blocks 6.a., b., c., and d.)
f. PRINTED NAME
g. CONTACT INFORMATION
(Last, First, MI)
(Email and/or telephone)
h. SIGNATURE
i. DATE SIGNED
(MM/DD/YYYY)
The Service member is not eligible for SCAADL if any question in Section 6 is answered "No". IF THE SERVICE MEMBER IS NOT ELIGIBLE
FOR SCAADL BASED ON THE REQUIREMENTS IN SECTION 6, PROCEED TO SECTIONS 16 AND 17.
DD FORM 2948, AUG 2015
Page 1 of 8 Pages
PREVIOUS EDITION IS OBSOLETE.
Adobe Designer 9.0
PART II - ASSESSMENT AND EVALUATION
(To be completed by DoD or VA Health Care Professional)
7. SOURCES USED TO COMPLETE THIS APPLICATION (Select all that apply)
DIRECT OBSERVATION
CHART REVIEW
DESIGNATED PRIMARY CAREGIVER
8. SERVICE MEMBER MEDICAL FACILITY (Facility Name, City, State,
9. PHYSICAL ADDRESS WHERE SERVICE MEMBER IS
and ZIP Code)
REHABILITATING (City, State, and ZIP Code)
SCORING GUIDE
Refer to scoring guidance in Sections 10 and 11 of the DD Form 2948 Instructions.
COMBINED TOTAL SCORE:
Tier 1 (Low Dependence): 1 - 12
Tier 2 (Moderate Dependence): 13 - 20
Tier 3 (High Dependence): 21 or greater
10. ASSISTANCE WITH ACTIVITIES OF DAILY LIVING (ADL) REQUIREMENTS RESULTING FROM PERMANENT CATASTROPHIC INJURY
OR ILLNESS (Use Scoring Guide in the attached Instructions.)
(3) DID HEALTH CARE
(4) REASONS FOR SCORE
(2) SCORE
PROFESSIONAL
(1) AREA
(Enter
(Include any pertinent information, as necessary, that explains the assessment
OBSERVE?
0 - 4)
score, i.e., in addition to what is defined under 10.(1)a. - 10.(1)g.)
YES
NO
a. EATING (Ability to feed self meals
and snacks. This refers only to the
process of eating, chewing, and
swallowing, not preparing the food
to be eaten.)
b. GROOMING (Ability to tend safely
to personal hygiene needs; i.e.,
washing face and hands, hair care,
shaving, teeth or denture care,
fingernail care.)
c. BATHING (Ability to wash entire
body safely.)
d. DRESSING (Ability to dress upper
and lower body with or without
dressing aids.)
e. TOILETING (Ability to get to and
from the toilet safely and to maintain
perineal hygiene. If managing an
ostomy, includes cleaning around
stoma but not managing equipment.)
f. NEEDS ASSISTANCE WITH
PROSTHETIC OR OTHER DEVICE
(Need of adjustment of any special
prosthetic or orthopedic appliance
which by reason of the particular
disability cannot be done without
aid; this will not include adjustments
of appliances that non-disabled
persons would be unable to adjust
without aid, such as supports, belts,
lacing at the back, etc.)
g. DIFFICULTY WITH MOBILITY
(Ability to transfer safely from bed
to chair, ability to turn and position
self in bed, ability to walk safely on
a variety of surfaces)
h. TOTAL SCORE FOR ADL
REQUIREMENTS
DD FORM 2948, AUG 2015
Page 2 of 8 Pages
11. SUPERVISION OR PROTECTION REQUIREMENTS (Use Scoring Guide in the attached Instructions.)
(3) DID HEALTH CARE
(4) REASONS FOR SCORE
(2) SCORE
PROFESSIONAL
(Include any pertinent information, as necessary, that explains the
OBSERVE?
(1) AREA
(Enter
assessment score, i.e., in addition to what is defined under
0 - 4)
11.(1)a. - 11.(1)g.)
YES
NO
a. REQUIRES SUPERVISION OR
ASSISTANCE AS A RESULT OF SEIZURES
(Cannot be controlled with medication or
require a complex medication regimen to
control.)
b. DIFFICULTY WITH PLANNING AND
ORGANIZING (Requires supervision or
assistance due to inability to plan or
organize.)
c. SAFETY RISKS (Requires supervision or
assistance due to a risk to self or others
and/or personal safety risks such as falls,
wandering, inability to cross street safely,
unsafe use of electrical/gas appliances,
stove top or oven.)
d. DIFFICULTY WITH SLEEP REGULATION
(Requires supervision due to sleep
dysregulation.)
e. REQUIRES ASSISTANCE OR
SUPERVISION AS A RESULT OF
DELUSIONS OR HALLUCINATIONS
(Requires supervision or assistance due to
behavioral risks associated with delusions
(irrational beliefs) and/or hallucinations
(serious disturbances in perception).)
f. DIFFICULTY WITH RECENT MEMORY
(Requires supervision or assistance due to
difficulty remembering recent events or
learning new information.)
g. SELF REGULATION (Requires supervision
or assistance due to any of the following
behaviors: aggressive or combative to self
or others, verbally disruptive to include
yelling ,threatening, excessive profanity,
impaired decision making, inability to
appropriately stop activities, disruptive,
infantile or socially inappropriate behavior.)
h. TOTAL SCORE FOR SUPERVISION OR
PROTECTION REQUIREMENTS
12. TOTAL SCORES
a. ADL SCORE
b. SUPERVISION OR PROTECTION
c. COMBINED TOTAL SCORES
d. DEPENDENCE LEVEL
(from Block
10.(2)h.)
SCORE
(from block 11.(2)h.)
13. APPLICABLE ICD-09/10 CODES FOR SCORING SECTION 10 AND SECTION 11
(Include ICD-09/10 code and clear text for each injury or illness.)
DD FORM 2948, AUG 2015
Page 3 of 8 Pages
14. HEALTH CARE PROFESSIONAL
By signing this form, I certify that I completed the assessment of the Service member's requirements for assistance with ADL and for supervision
or protection.
a. SIGNATURE
b. DATE SIGNED
(MM/DD/YYYY)
c. PRINTED NAME (Last, First, MI)
d. RANK AND/OR TITLE
e. TELEPHONE (Include area code)
f. EMAIL ADDRESS
15. DoD OR VA LICENSED PHYSICIAN (Certifying Part II)
By signing this form, I certify the assessment of the health care professional in Sections 10 through Section 13 and associated dependence level.
a. SIGNATURE
b. DATE SIGNED
(MM/DD/YYYY)
c. PRINTED NAME (Last, First, MI)
d. RANK AND/OR TITLE
e. TELEPHONE (Include area code)
f. EMAIL ADDRESS
16. COMMANDER OR SERVICE DESIGNATED REPRESENTATIVE
YES
NO
a. Service member's permanent catastrophic injury(ies) or illness(es) were incurred or aggravated in the line of duty.
b. Service member has designated a primary caregiver who will be at least 18 years of age, with the exception of the Service
member's spouse, and is also not a military member.
c. Service member is not receiving outpatient or in-home services (other than respite care) from another Federal agency for
assistance with activities of daily living or supervision to avoid harm to self or others, to include TRICARE.
d. Service member's caregiver is not receiving aid and attendance compensation from another Federal agency.
e. Service member
is eligible for SCAADL
- OR -
is not eligible for SCAADL. (Certifying Sections 16.a., b., c., and d.)
f. SIGNATURE
g. DATE SIGNED
(MM/DD/YYYY)
h. PRINTED NAME
i. RANK AND/OR TITLE
(Last, First, MI)
k. EMAIL ADDRESS
j. TELEPHONE
(Include area code)
17. SERVICE MEMBER OR DESIGNATED REPRESENTATIVE ACKNOWLEDGEMENT AND SIGNATURE
a. I acknowledge both my Physician's certification of my SCAADL eligibility (Section 6) AND my Commander's or Service Designated
Representative's certification of my SCAADL eligibility (Section 16).
I do intend to appeal this decision - OR -
I do not intend to appeal this decision.
I know I cannot receive special compensation for assistance with activities of daily living if (a) I receive aid and attendance compensation AND
(b) my caregiver is also receiving the VA Family Caregiver stipend.
b. SIGNATURE
c. DATE SIGNED
(MM/DD/YYYY)
d. PRINTED NAME (Last, First, MI)
e. CONTACT INFORMATION (Email and/or telephone)
DD FORM 2948, AUG 2015
Page 4 of 8 Pages
INSTRUCTIONS FOR COMPLETING DD FORM 2948
(This application must be completed within 30 days from the date entered in 6.i. on this form by all responsible parties.
If not completed within 30 days, a new evaluation must be processed.)
1. TYPE OF REQUEST:
“Initial Application” – This is a new application. Complete all sections of this form.
"Recertification” – This is a periodic (at least 6 months) recertification of eligibility for SCAADL compensation by a DoD or VA licensed
physician. Complete all sections of this form.
“Appellate Review” – The Service member was initially denied SCAADL eligibility by either a DoD or VA licensed physician or the
member’s Commander or Service Designated Representative, and is requesting another review and final determination on SCAADL
eligibility. Complete all sections of this form.
PART I – ELIGIBILITY CRITERIA
(To be completed by DoD or VA licensed physician)
2. SERVICE MEMBER NAME. As stated.
3. CURRENT PAY GRADE. Please use letter and number to convey current, not anticipated or projected, pay grade information;
i.e., O1 - O9; E1 - E9; W1 - W5.
4. SSN. Please provide only last four digits.
5. DATE OF BIRTH. Enter date as a 2-digit month followed by 2-digit day and 4-digit year (01/01/2015).
6. DoD or VA LICENSED PHYSICIAN.
a. Certifying Part I – Select either Yes or No.
b. Certifying Part I – Select either Yes or No.
c. Certifying Part I – Select either Yes or No.
d. Certifying Part I – Select either Yes or No.
e. Certifying blocks 6.a.- 6.d. – Select either “Is eligible for SCAADL” or “Is not eligible for SCAADL.”
f. PRINTED NAME. As stated.
g. CONTACT INFORMATION. As stated.
h. SIGNATURE. As stated.
i. DATE SIGNED. Enter date as a 2-digit month followed by 2-digit day and 4-digit year (01/01/2015).
PART II – ASSESSMENT AND EVALUATION
(To be completed by DoD or VA health care professional (Sections 10 - 14); DoD or VA licensed physician (Section 15);
Commander or Service Designated Representative (Section 16); and Service member or Designated Representative (Section 17)).
7. SOURCES USED TO COMPLETE THIS APPLICATION. Select all that apply.
“Direct Observation” – DoD or VA health care professional directly observed the Service member's Activities of Daily Living (ADLs)
requirements (Section 10) and Supervision or Protection requirements (Section 11).
“Chart Review” – DoD or VA health care professional used Service member’s medical charts to determine the Service member's
Activities of Daily Living (ADLs) requirements (Section 10) and Supervision or Protection requirements (Section 11).
“Designated Primary Caregiver” – DoD or VA health care professional used Service member’s Primary Family Caregiver input to
determine the Service member's Activities of Daily Living (ADLs) requirements (Section 10) and Supervision or Protection requirements
(Section 11).
8. SERVICE MEMBER MEDICAL FACILITY. This is the location where the Service member receives primary medical treatment.
Include medical facility name, city, state, and ZIP code.
9. PHYSICAL ADDRESS WHERE SERVICE MEMBER IS REHABILITATING. City, state, ZIP Code.
10. ASSISTANCE WITH ACTIVITIES OF DAILY LIVING (ADL) REQUIREMENTS RESULTING FROM PERMANENT
CATASTROPHIC INJURY OR ILLNESS.
(1) Area – This section evaluates a Service member’s requirement for assistance with ADLs in seven areas: eating, grooming, bathing,
dressing, toileting, needs assistance with prosthetic or other device, and difficulty with mobility.
a. Eating. Ability to feed self meals and snacks. Note: This refers only to the process of eating, chewing and swallowing, not preparing
the food to be eaten.
4 – Service member is unable to feed self and must be fed by Caregiver all meals and snacks or the Service member needs assistance to
receive all nutrients through a nasogastric tube or gastrostomy.
3 – Service member is able to get food to mouth but needs assistance with using knife, fork or spoon; or needs assistance to receive
supplemental nutrition through a nasogastric tube or gastrostomy.
2 – Service member is able to feed self independently but requires intermittent assistance or supervision.
1 – Service member requires no more than cueing, coaxing, verbal prompting or light touch to feed self.
0 – Service member completes task/activity without help.
DD FORM 2948 INSTRUCTIONS, AUG 2015
Page 5 of 8 Pages

Download DD Form 2948 Special Compensation for Assistance With Activities of Daily Living (SCAADL) Eligibility

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How to Fill out DD Form 2894?

The form is made up of 8 pages in total with filing guidelines provided on the last four pages. DD Form 2894 instructions are as follows:

  1. The form begins with a Privacy Act Statement, legal definitions, and eligibility guidelines for SCAADL;
  2. Block 1, Type of Request. Specify the reason for filing is an initial application, recertification, or appellate review;
  3. Part I, Eligibility Criteria. The box is meant for determining SCAADL participation eligibility. A DoD or Department of Veterans Affairs (VA) licensed physician fills out the service member's name and current pay grade in Blocks 2 and 3;
  4. Block 4 and 5. Enter the last four digits of your SNN and your date of birth;
  5. Block 6. This block is filled out by the evaluating physician. SCAADL is granted only if all answers are positive;
  6. If the service member is determined to be eligible for SCAADL, the form is forwarded to a DoD or VA Health Care Professional who completes Part II;
  7. Block 7. Specify the sources used for completing the DD 2948. The information about your medical facility and the physical address of the place of undergoing rehabilitation are given in Blocks 8 and 9;
  8. Block 10 contains seven ADL areas to be assessed. The physician must score the service member according to each criteria on a scale from zero to four, with zero meaning that the applicant can complete most tasks independently and four implying the applicant to be highly dependent on a caregiver;
  9. The same evaluation is performed in Block 11 - Supervision or Protecting Requirements;
  10. The healthcare professionals and commanders involved in filling out the form must provide their personal identifying information in Blocks 14, 15 and 16. The applicant certifies their recognition of the results of the evaluation by signing the form in Block 17.

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