0990-CHIP Part A_Attachment K_Site Visit Consent Procedure

0990-CHIP Part A_Attachment K_Site Visit Consent Procedure.pdf

CHIPRA_ Children Health Insurance

0990-CHIP Part A_Attachment K_Site Visit Consent Procedure

OMB: 0990-0384

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ATTACHMENT K
SITE VISIT PARTICIPATION CONSENT PROCEDURE

PAGE INTENTIONALLY LEFT BLANK FOR DOUBLE-SIDED COPYING

To be displayed at the end of the email invitation. 
 
Please let us know whether you are able to participate in the site visit by 
clicking on one of the two options below, then replying to this email. 
 
 Yes, I consent to participate in the site visit 
 
 No, I am unable to participate in the site visit 


File Typeapplication/pdf
File TitleMicrosoft Word - CHIP Supporting Statement Part A_Attachment K_Site Visit Participation Consent Procedure.docx
Authorkruffin
File Modified2011-08-11
File Created2011-08-11

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