Get the free oa hipp eligibility form - cdph ca

Description
My registration in ARIES does not guarantee services from any other ARIES-using agency. Wait lists or other eligibility requirements may exclude me from services at other ARIES agencies. By signing this form I acknowledge that I have been offered a copy of the ARIES OA-HIPP/OA-PCIP Client Consent Form and have talked about and understand my rights to confidentiality with respect to ARIES with the staff person...
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