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Notice Regarding COVID-19 Reporting
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Electronic
Files
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and Variance Application
Provider Survey
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Incident
Reporting Form
Prior to entering any information, select Save As to save the Incident Reporting Form. A window should appear, prompting you to specify the location in which you'd like to save the file. Select the desired location/folder. Enter a File Name. Click Save or Ok to save the Form. Complete the form and click Save. Email completed form to [email protected]
Top 10 CCI Rule Citations