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CTRAC Quarterly EMS PI Reporting Tool
1. CTRAC EMS PI Tool
8%
1st Quarter: Sept, Oct, Nov (due Dec 31 2009)
2nd Quarter: Dec, Jan, Fab (due March 31, 2010)
3rd Quarter: Mar, Apr, May (due June 30, 2010)
4th Quarter: June, July, Aug (due Sept 30, 2010)
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Please begin by entering the following information.
Name of person completing form:
Name of provider:
Quarter Reporting
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