BHSF Form 96-A Acknowledgment of Receipt of Hysterectomy Information - Medicaid Program - Louisiana

What Is BHSF Form 96-A?

This is a legal form that was released by the Louisiana Department of Health - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on February 1, 2020;
• The latest edition provided by the Louisiana Department of Health;
• Easy to use and ready to print;
• Quick to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of BHSF Form 96-A by clicking the link below or browse more documents and templates provided by the Louisiana Department of Health.