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Form fillable pdf template for use by your appeals reviewer to consistently and thoroughly document appeal decisions. 


Contains a fillable form for Acrobat DC and free Acrobat users.


If you require a modified version with branding or verbiage based on your specific policy, please contact me at

Appeal Report Template

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  • You can cancel your template purchase for a full refund within 48 hours of your purchase if you have NOT yet downloaded any of the material. After 48 hours following your purchase and/or an initial download, there are no refunds.

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