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Appendix 610 Form for Individualized Health Care Needs Assessment (HCNA)
The following vignettes are slides with audio
Section 1: Factors Triggering Health Care Assessment
Question 2, Part 1: Applicant's History and Current Functioning
Question 2, Part 2: Applicant Interview Summary
Section 3: Identification of Functional Limitations
Section 4: Health Care Needs/Barriers
Section 5: Reasonable Accommodation Consideration
Section 6: The Recommendation
Section 7: Recommending Alternate Center
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