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Tracey-Ann Ortiz

Employee of the month

Owner/President

John Smith

Caregiver of the Month

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• PCS Required Supporting Documentation Checklist
• PCS Plan of Care Form-Unlicensed Independent
• Physician Visit Documentation Form
• Medicaid Physician's Written Prescription for HHS Form
• Parent or Legal Guardian Work Schedule FORM (employed)
• Parent or Legal Guardian School Schedule Form
• Parent or Legal Guardian Medical Limitation Form
• WellCare Authorization Request Form

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