Wheelchair: Basic AND Rental: Evaluation and Prescription Form (04/11/2023)

Health Access, Dept. of Vermont

This government document is issued by Health Access, Dept. of Vermont for use in Vermont

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File Details: DOCX (69.4 KB)
Source
https://dvha.vermont.gov/sites/dvha/files/doc_library/basic_rental%20wheelchair%20form%20for%20web_2.docx

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