Form 272M Mobility Evaluation Form Wheelchair (Fee-For-Service (Ffs) Program Only - Not for Managed Care Program Use) - New Hampshire

What Is Form 272M?

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

FAQ

Q: What is the Form 272M Mobility Evaluation Form Wheelchair?
A: The Form 272M Mobility Evaluation Form Wheelchair is a document used specifically for the Fee-For-Service (FFS) Program in New Hampshire. It is not intended for use in the Managed Care Program.

Q: Who should use the Form 272M Mobility Evaluation Form Wheelchair?
A: Only individuals participating in the Fee-For-Service (FFS) Program in New Hampshire should use the Form 272M Mobility Evaluation Form Wheelchair.

Q: What is the purpose of the Form 272M Mobility Evaluation Form Wheelchair?
A: The purpose of the form is to evaluate an individual's mobility needs specifically related to wheelchair usage.

Q: Is the Form 272M Mobility Evaluation Form Wheelchair applicable for the Managed Care Program in New Hampshire?
A: No, the form is not intended for use in the Managed Care Program.

Q: Can I use the Form 272M Mobility Evaluation Form Wheelchair if I am not in the Fee-For-Service (FFS) Program?
A: No, the form is specifically for individuals participating in the Fee-For-Service (FFS) Program.