This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington.
The document is provided in Somali. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the HCA13-0031 Oral Health Connections Patient Attestation Form?
A: The HCA13-0031 Oral Health Connections Patient Attestation Form is a form used in Washington state to attest to the patient's oral health condition.
Q: Who is this form for?
A: This form is for patients in Washington state who are seeking oral health care.
Q: What is the purpose of this form?
A: The purpose of this form is to gather information about the patient's oral health condition and assess their eligibility for dental services.
Q: Is this form available in Somali language?
A: Yes, this form is available in Somali language for Somali-speaking residents of Washington state.
Form Details:
Download a printable version of Form HCA13-0031 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.