New Appointment of Representation Form (CMS-1696)
A revised CMS-1696 (Appointment of Representative Form) is now available at:
http://www.cms.hhs.gov/cmsforms/downloads/cms1696.pdf (pdf - 2 pages; 116KB)
The previous form will continue to be accepted until further notification is provided.
Please visit CMS' Website for a full listing of available forms:
http://www.cms.hhs.gov/CMSForms/CMSForms/list.asp#TopOfPage
