DSS-1473b: Request for State Appeal 1473-Addendum for Expedited MAD Medical Determination

Request for State Appeal 1473-Addendum for Expedited MAD Medical Determination
Form NumberDSS-1473b
Agency/DivisionSocial Services (DSS)
Form Effective Date 2022-03-31T14:05:00-04:00
Form File DSS-1473B v2.pdf