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Adobe PDF Adobe PDF document  Invoice for Completing a Disability Determination Package, Medical Review Package or Providing Additional Medical InformationThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill, Save, Email & Print
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Form Classification
Classification / Identification:
 Form Number:006-3261EEdition date: 2019/09 
 Title:Invoice for Completing a Disability Determination Package, Medical Review Package or Providing Additional Medical Information
 Ministry:Children, Community and Social Services  
 Branch/ABC:Social Assistance Central Services Branch  
 Program:Financial Services Unit  
 Purpose of Form:For health care practitioners to bill the Ministry for their services in completing the Disability Determination Package, Medical Review Package or providing Additional Medical Information to the Disability Adjudication Unit.  

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