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	Assisted Living Annual Report Current Survey: 2019
	Assisted Living Online Survey If you encounter technical issues which prevent you from completing the survey, then please click the Blank Report Form link, print the PDF, manually fill it out, and FAX it to David Rasmussen at 501-569-8538. All information given in this report should be for services rendered to clients in Arkansas. A seperate report must be submitted for each county served by each agency. The Survey due date is February 1st, 2021.