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The following forms are in Adobe Acrobat (.pdf) format. You'll need the Acrobat Reader browser plugin version 4.0 or higher to read and print these forms. If you don't have Acrobat Reader, you can download it here for free. General Forms:
Designation of Beneficiaries with Contingent Beneficiaries (RS 5127) New York State Health Insurance Program Claim Form
Physical Examination Benefit Form
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