%PDF-1.6 % 138 0 obj <> endobj 155 0 obj <>/Filter/FlateDecode/ID[<4BD85A203F5CE1408F4A9D6D5F361FAA><028A43E61C88D546B6E7053926257155>]/Index[138 32]/Info 137 0 R/Length 86/Prev 68845/Root 139 0 R/Size 170/Type/XRef/W[1 2 1]>>stream hbbd``b`: $wL H $l Rbg@ܗ @!HquĹv&FI#/ 1 endstream endobj startxref 0 %%EOF 169 0 obj <>stream hb```c``Zπ L@Q zs60/`h1r \jCx96T(#qosnƓ` o4#Ҝ !|[p[>jBD٘ᢼ \P}L@ endstream endobj 139 0 obj <>/Metadata 11 0 R/Outlines 22 0 R/PageLayout/OneColumn/Pages 136 0 R/StructTreeRoot 38 0 R/Type/Catalog>> endobj 140 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 141 0 obj <>stream hԗo6 = [6p&5zXHm%Yyذ6ER(0 %Lh O*#̀hJ$dDiDт &g ^ 0>%Er[,'Ϝ\&uR^ oՋWaKnU ](T&gIY,fS7MFu)fOzV!hV^&żEV=mQ,a^|`d0 xWN?nrZCi2,+ir"m?Sj1&l';t/b]>WFU. Sp;je|npKcy7z]/}^ zlϨK5_&XAJ&۷šb7 E5ơެ W} '.K&G\'ݙ,?ט fܒ)t*5}b)t%iz,6\W2|ߔM=xd٨rgjwu^Lru35Њp P(JfD#YBF@R·>?`1Qd(s+1b#!k z삟{Ϥ Q@n qsq|ލ"lnB5wqVK§wG r}X Wuj ;.K-vveNNh (*Bv&*I\IOĮ`&O;ǎ-B|*v6>.O]*QUkS5T^)cJw:)ņj"/j1)n2OV*ï: ˿)\Qx*P16tBy唴]I[}&;_5-#748N^TDR) NRgQgZ4k1_;ʉOi@PQ wKR{‡'t;wiuvqh7+}TT]9_HNЃq=[Mڕ=,y۹vKAԎ޿~ti$yφ?CWҖJӝ^_27NoYF~,밿6;`Q(n,+ޓ]JO)6";\;\\W#aYzp ƥp p]}ʨDzKq$KsD0ףc{*ݯx endstream endobj 142 0 obj <>stream HTMO0W1''Ah%ԥBX&wYvi{%=~ތ|O?C)A.xR\H5OSZt eC`tA\U 'X5JB%z%%(M U02 aDs,2+\1D0` .#Rͳ7B`w~r\zX@ C#y<釡_u>stream HtUMs@ Wv ] N{=urp:fj1NW<%AڕIݭ /<_~&cӺ4dD}C9m 5YvGss5·kGt.ί޲?0d N`[ &KÓFP+`qYAc@On:c89?<$=S  ^1YBTEGhV*ڋ3`!)[V% 2HO.zLtyV3؛A#nxD6K+<_z(eܔ(a]2~kWQRTjƶ_f/pd?т b"atT}=%U`td3 "Ϫ>w̛$;lCOhc \tzn=.x4*B$a oN+* ޞfV W0&0V"wгӳd&Yb'zlGOŵ2aT,pDD9WűBdJ4 u90@]fzGY$aሼꈺN2vAc7ih#^Q.ւV^4v ?nuG[O6>r%6e3JaɄTgz79~w~;Zs>stream H|TM@ 1#-J=UUU,I,m}9LU/gٞCfYU ~w}Z[ȠjWrX]]σyU'?zx 9Qݣk5ݠ;{NW%|r$o3 w'+3=vj_#pg3JBuHDITLԯHPޜBX[Bm}Q&MDR% Ȏn-%=jҳL:+ާ~:סP,aH6Caa6ڸ\+CK}ÌquN\;s/,i CPk[R]F3AKu@CPQ9Dfe9-^'2;ZIZ:iLqkѷ[0jMZMBm4?J= hI;DJ6p/($AHRY9wPg*d7McNShO5ne!F[lqGtlA Gͨ.KEe]f0a*%X' od endstream endobj 145 0 obj <>stream HtTMo0 Whbɖ?~۰=x(/qin9nv$|$U}:-TKnQ,Dje.!jM'd]?uQ=*'0m)iE_W z˫21˥2FF֮N֔CA9 rb H!u:\-̍6|oo*%׏~P)DOH.WkHFg%tc "C\vQfm9ԜD N4l5r U5[%pvv~I!&F)e;f4IY ,nہ6v)1j7~Sw`F]Z v K>HdIDrXsGSrVo `?>ߕ[eƙN,|yqUe1zuï#釂yICAɡ|+n;v_uW7 ZfzOjU`+5E&gkafuPM:t p^-4feri2V 7df0(~# e8b"Rcv)P[ea,dB'd&%ݽLq++@?<P/f^9F42ȃ~?IT^f~ 25W™!? 0ڐ endstream endobj 146 0 obj <>stream HUMS0 W:@a0mCIthNJ%;t{;' Tk0!Q2+3HRP%qZ[W@ UQ@2 C/ȁBBpSž 1kOz<ҽmp((klZa('r <Ɯ傲^ `Hlx_ k endstream endobj 147 0 obj <>stream HUMs@ +tvf0=|t2qڙWJ8q^jWOғmdm ;I,EnB !x5!nOW}~ v}||bqe`A4PT`9'N[y4.X= 3H =**w.-t'jo/g)zbxӨ"w]@+ OVVI!4ŷ䣿(3z+rHK/ιZ 0].&Yщa; 80 Ah; TI1-P%KȨcxP֙fê7lL:.c@9bU&DtԽ{} ]3G+s endstream endobj 148 0 obj <>stream HTn0 +xV$V.;tX|ۆ!uCtu ?m:bIM>>=rԴWIUPGJ*e!N:6ՠZG_ⅰDb n+(x(0d_~m$6;mGWw+U#EX4 "C&-҃c+,p?.!|Z'&˛k kXTL7zJf/=cπdTJl[)A #Gq/2G~(hfK{L-2e|!o/)~)!NdI`mt%* ?^a9p{VJJ lJ-UNִ"ڶFg83z vu\:BfC^5˙WjLArꚮfm4wls{RǬB7g=Enܜ,CoWIk} N>q ?GWHE2LcxEãK\b.N߮3Bc=2̄w*ejcHys endstream endobj 149 0 obj <>stream H|SMO0 WIҴې@Rouch&=N C᭨2G@ʒzs'/5hUcՖy ]^r萕B!deX[˾MdV3XݲLI#u VdhN?A"N-}zIF頗Fd1yN|Iio=!H@93w"v+G%S>{YR)QeTL;{z~Ic/Β06y DocR覛yJ4݌ Z{P6p8o&0]MB<&DLI$O".$R$ ׫C+CeaӾ/D ui%RW:lpU0ٳ{ ؓ endstream endobj 150 0 obj <>stream Hb``$WR~  |@T # 2 S/`M.(*(%8H8c- fԉd9@6_IjH9(3=DR1%?)U!$5X3/9 ($5j%V*'&*r"(,!!0b;CҢ2(ɘ I8/ endstream endobj 151 0 obj <>stream Hj`@  endstream endobj 152 0 obj <>stream HV{t]@6 lB6AHHp LئpqyH-,T@ X-iSh9rz"EXRNlB$ӹ;3w7$#gVx/f| ^ {&zRPlAU 1W5yo Ve3@R,H/ƃ뗭ZljS`jaj!ذ,A)^[\VӲpHƏaEMÜ#X Ws*nu4ϐQ+z'IU%AvP|ԣ}CSJh#N7vN ̏;1y]] =ļ8$wWXӸ4 eh3#X\?ߡ H_` 1^I7[0Wȧ'`C_a/]Tg,Iy!$`{߁=8?H{xP1a;NhHr4MQ]*Ek#Ɗb%DX% CDIqY̗^RHeT+Wv(rCJPujP~ Vgf"s*x g!Oj9 LcZǵ^UW=|o<>%-.__rQ.>BxVzjm6Y89/b*v=U JɲTΕBJ˟˽r6"|LYlT+c[_H@ 3jzۖacE6:ǧ^[OM~CJE6'ڠ mX/91Uq6P- r< ᬺ*dUBم;a,tKE=GL?BcB!* +)REv/ɌO8 G2]CP^1Y0EL]cPDc)8E4}csK@{JD᎛m,N R> >fW#9_[_9#z~H]9‚y3Q#G 6C2qi>8 #=-L3)1nS)9^$YCҧLɵdAAXTq3-ktwX,ɩ07GqXעTUc~k׌q8dAO.мŚAk{<_$1{jrsIHd69EgDo~Dѓ2b[!26} ˟c'/2O2&6a[`i o:(TW [>RoSeL4]qt6+Iy/Sӥsqs+UY"ҧrGZHH|:g=j_~QF5b'v[rkf:u-5u;%LװXOzwy#;6jהc,ssVGDˇ2mП?rY 9"FckX l!lKxW5SQ_c*&ߝN%<苉3w9sݻsd%C"Dʖ-1QVe)RJΡ-wzrSjMnanQanaD75qB&͐MfPN{e)jrk<55bvuCk׭>;yjn9sF4L/XI-P6]jqk%9FAԜ(mݬP1_Ju%H,)"I=EV6zB@9l/V{M~Ydo~: a`34Ewus1[`tVIWDΧM,+F5%\d9@vdE\1cT,]:6XQ [ǐ !;7l7⃎2$?C1lK:mxY*ޤfp kx&_ 9 Ø |u[^̵]+wxf٫tw~ʱ6O(WsX8Lg@PT [ifscXWFeEu7`v>AƏYe6&g /;Bvc7?fpY3H +U%yBeZ<[8ӈ[%O )XIB/MGL}k-c;LY~)K lhd 3kgЮHM A5' $E{X E6߯u:}֭]9'ޥFg$.(&AC(43ɋHhz=DF/c0jBf@Gm4B{(臌ѽ<>_X'B6](],Sa70Gh+y+TNV:ib NNV{r\.9%JawyF+/u&J{/$^j)/Җz[Yd}W()%٫${Jr\$+$jŮTL]f**ә/<:Ae+'YdVE`@mZ!gfbj띮4wR6?CMTO+TO)ۻ& C*ԕf:Kib,sX0 7:mr7txG.LJ M) vB4IMZGAꄿ+5^Np!SfS Q^euZ@w.GꙨMx.Wqw4s$RO<^oF[B]o"4YtlO,2{4e>stream H\j0 ~ Cqv1ȡXpl%3,QC~:?[>27 C 8DžBc u6{Wn7٤:gZk"ΙW8>stream HWTW~XPU]]$V$cIL4Z000"UEPQ(2TA ,4iCǡ e(CG0ԽÏ$ߙy/}{{ANAq'5 }$i&gULr>`, Jkڡ&l<aJx/I2F9t{w 1÷*鍌YdDLNai-9UR~J*Y-Zdd_ 7<5dE7wV+4_IdT1q*խs!pjD^/_J~7C:$ٷ+ѱx", gK;'ʮHPWK.W7Uw6IQj>ÉBKl m[1\U@dBq.%),Cˉt/m4VBMxi89s@=!18S;l'Lu[ۻJr@dz#nu]G?\Gk-t,<*MV)0(v0 ˀvQY= 3hyL+Ŭ"M=}wRfJXaC-(`2 .^]%̆1vvRibáRp씠4]v4%NRY 1J2ZaO֞FbmU9j)$WEK!)c$k"鼐نCP>yBLx wEg2_Z"VE0ճ ڢe{ק HPSyD)V+47Am֊DOVCkAi+4WQlnʚf/,)5SA\Љ}ζfG#Mx =gK*UȨ%Yʛs$5A§|ÇOlJ8#a9d8oh 5\)h! RJ}?5i™hjh''h_v{qZǛJQG)dFp@#J] C|*Ǎ}&hI+a"!oG8^^]R"*SHEv٪a# )Bs>悉`B0i2tOD/"t[bIT$vabqNa#`Lju ҉ɒJ_zTp/cs M,u徿wA)ѭ֘Qie#X݊|$g\Vb-ܨEr_^(jž\ &e|O[{9HDɐ󣑿St@cwcƖ$C lRzOYތ٣zUU-/įW^.EaOG)AG0ICl)5GSS tG^ ֍M)StçFTpt.6O]]Ǝ9j} ZyħמE+ħ 1 "hJ+Bf1,(r┒˰RYeS?Q-)-s-;Hz4.d=8Q qLPjt+0I]"7hf)_ѲD>hiR>֔2aiʬn^ŌJd4󤬂]& ֙Mx,]x`%e+`\^RAh>SF:_H@) UМOɐ3_mr1K:<g ,͊T?М$'A$مYފƖ#!ؑqC/2Rs* Zۭ kL lB>h'gp*,ݝD J-vL8X4t8zz$B|ƀG0a9nj2Sˣ^6չXħIE#'*n9{$$g}:#&1Kg`gԂ,z>`Qj`\N1͎'^^VwW6S3Pԧh==TOVsJ5Mֻ / ?q&LRLV3}1"Ԥr载}Si4~Es Q7A9*Kw;_wB- tNm D IIBt6[LEQ>T\f^*n#mL@;IH2!B5=Ծ7bh΅6G|,W?$zơTT".+lť*H]o?꫋{\Fg+RFHDIvaDb9JȨi>Oq]hmCqu-dе{am6'gJ0w'<ɺƶva*^t#Nr%%=οsojsM O|QQƼ~c:}#ĆHP|j,@QQ UtK((@Q#QDE7)3y0(d+g5~Ou#$s2STB< %zgnM,Ark*!I(ԙ_2U A|"'n׋:[;A;M58ao7̑w@fz鎁dyz J҈ׄvGS ÒaJk{wD!mZ;,)JTK zv4TrGx Àچ>Q"΃LM7 +#&, [S]0zHY+S[:xh|}5҈GpzI/wd*u8eUx<8S/kd u?< s%,w=!IW SW6a–ܺ{8OM[EPPU.w_[ㅄ,J*k +zk2%lr!ՃsUKP,EWDLm7OD$,MϺͻOIcُD 8b+ ^|)S9syyEgAvi05mXJ$n7x0T/Y lB{VZV(?jS7|j"}L哵G{_|S\bوu2pl&q>)AԿ̙*cOZD1L?IJ+G-wX$?ʔ=/=}x_#bͻv@@k}£y [fpE (|%7\>”$Ȯ =~-L-\C;`JPD~jI2vh!P˟d1lsLg~ ۋe5&d(s14oQU=%EIĩ({МY;! 9 .S1xt^M!sB+ә6Y uӯ\.*ikx%(Cª=ݓ)u¸ŞV[DfutM=c>E֞$k-x`)P1[uӫo\@9^(PeDӒM X\؁1lRNsLĨrF| lkq 4iJ{/1Q`l1B2ctp(E):8oggX9qNMRUG(8mf&?ȯ5*9R(%]d4eF(g3rgLejw.ʮEJIeUt/t=oyy3ZZ}JM֍=o Tg{m`/"(&/GjZ MW~"l*}1:w!ܬP?oN =U HrʺW{dstjI=ۦ.xAa9Z]EuIޥh(`6[BH:ڽ-d2Bx*h\R/P9YP]+ 0ciphysvװž^A7P^!9rwk_{՞ &+-= p7>sK{7nl˿&f!"|GBlZ)61r1yS ekv(9B)y1$zPPs+w8;u8&S#OD{2, BZzrA>&4vtMQņltsn%>Y0c ѷC49v+g!"-x9,S6"ӇN5vz>&Yб Yi1g5"0MW0Ƈ5_:{q>ic8f2Smaa~Hy? ]ѹкo8 B#?=}6)G}xIDNxB::R9lNJΪҶEN@N76urVw/Gd=VeŠq(1z6Qhf$B'W[F%Ѳ-NDu1ɲ Nd`D (Zҥ𝑞WC|2(DTu66)YU4RC2ƏEO齖Gyie)U5*77 $:m֎N,9@0#AA'fڻ{qId$N>i#t f ౏H Y5G2WRxVj}@h&kv7v "5Xࢮ Rp{bSun2׳Gb>Η`jhY܄@*k=%4.gt)1=-\$RG#[,)[{ (oaK2vs7|fk*<YsNo,"@b z\^sȩfCeB_ )ʂ蠈/^ȞȦuJ;auJaՅ{uߎW4Mod:z:eDuWtC X&Üj跰;/'ϷuF&-ihj\H4*,GQZqJS#,k;䢲Fd+:£򐼰*z񪭛ZXB/  v삚Cy6x΍`w>Rm K9%q}PD6f5 (@BrlG7w688Tu c -pAs GZc\lQ־F5l}3c%Ҹ{VSA:qu^/5V`x A*^)&d.(ճt=H X (/:^^w`0P endstream endobj 1 0 obj <>/Font<>>>/Rotate 0/StructParents 1/Tabs/S/Type/Page>> endobj 2 0 obj <>stream HWko_@EDq\.@E$/7QQE%G$Y.I)N~0Lc89gŋW3q外EiօT1Rfy:9>b+bXRH1:).NbOJL`#j%EY!"[~eY"G-M8ΕT)sqL;y==q1#-ħL | pl6>]v{t]lYhjeBN c [;>?bf-7b<_|w^qnv9>Y+)t8z ޏیJ fFRɦ1Q^嶀aIR\vY wuȬ*HG D Lm CZa;I}yiN  פֿ ( S5MQ%#Ї?KFUy6h%=TdsIt WF]6j Gu*CQ𪗚ϑ,[VIms!SHr3`V~Whe6|Zftz(;5Tu͎b%Pq'vCE2Qޫ#u?U Q5<dEE[:r~k$Kk(R(ۮJs`;Ps޵ʫ}ŬSeD^ o}N\KhlP@0ăGy^`bņ& _B`Ժ.D*:>곉ej6̟=jg""2=DN.턓Ĩ2Z@t5Vtuꊣ BAl_bqk~yC8#ցe  tEY0ޛ='{N_,>A毧PmgmhO JcjGX*7 f[p5`JOt(@:kc Y}.SGQ'M"~RU@6p yDNv0py j3U{i !t_pa]񰾋 HvpŠ䘊JW#u_ZAVg K crKc2 cCU*$ˣ=>=k?BaI~c<|L̖IQDЄZ5?X#ȀyxY*H*ȫI<ևE bdu$ml 5NJw'dkt|C$V5VQ&iG,RpgɎ6d;F4;5yW"UJY2* ~ٗI֍Ae:z+toT,{.34_MG6_C'<ܺMڋ,;#tݠYtb$K]hy6l@K~C+EϻQyrKFХ=2ᬿpD9$ӜdIfo 2I捯=FTNu^pAaIؚ͚z3Q7ڨ|//ڤh]|xon=e S C"RQC v2]@u-Ue0uˠ4w9M(./7DS[x۲=?<ꖸf4MDW]oF}ϯ`ACXC>/DM)%R~gTll"g8s?=ܿ}/cmd@}4(¸s$=^-`W!ZZ-|~Z)"eI@:7O*gnR2PR1J#bl$?aފ/Ұ Z]aKW*_z1Y*t,G`tN:>O%gCO:y5ړcRɚB*a_[Ry"z '2}Z1P rw[Ý%a!Qw_n @hԐQNO:_R̔ųU`v C6IloM~K< +Hu x K)MvT8>?kc4 8bnYw0Flp\xmwI gU9V+>kp^&8ҍn. o4Y\Viso/Zz) /|fPE^ccqylVV8~ =:֧nhfL]vأ|?ɫvvlH%`Ty,*".R&?g}:C9dNJQQqZܣbJJRmFy^$$&i~.Rb{~qD.]U e^F2+@63ǂroA@#-^v6?2R9r]p(ԬH5!%]^5=guS!p < D9 xXp> Y -?.0l ʂЀ"B y;#0!X ;}Hmz{#&ejEv׋5[-äTm~!p3)iǶ%qil*d( |zm $X&D:rXAjݬRzٌEĈVRƻ&k͏LW3O'wВѤ "p . x OZ+jV%qKqZEF7ͬI+aLKt"F+$N5A- GQ?M[/a)'2{GLE*3PhZz\HCQ⡝'a{.//hx1]vxUrS-zA֏Le$/ HRUx听2e5)W a]PQ{ѶQ Z@9UjI'Pj^6|Frcni\LE}&0!!C% &V Ȓ̴i@< 3=}o{+{gk|{gqn՜/;4oJOT$;94 6"w/V(=0琺?.+P*+䎃OPK<ggE7T BIu^t\6;`F XD~N CMJfD#֝B˙+lj8%E@aza//--U4ÔұiK 7AZohCz=zl o3bi޵8~?sVW[,p8TNk8ǜ'6єӃQ?1Y?֬50š?3#@Gż7r.Hh=ZL)!=:I7 \9E~FuL-O2-w̓@/)rߣ @CsV0t#*]X3(}#UNrU?<4-.)!Z*O1/GOZx?j>G7$WIh-߫{@ɸ^=0bE,ԼOf-waP0M +MKMB ʟ~W6 ^`cZ#rHߪ$z+g{wجm6ʼn,VzL >{9GLиnNǰ(?Qɂه$glԜDm"~>ע4{-^^ti!G>p]qMwK"7TT(8oE^?% ;&:ʐ} 5H ͐lZz@M b9N 6jb 6mf ާ+3$/{alڽ5F)2ψBvot_u5N#׎FU|1Q)Ava) G!Y5܊.W/`Ÿ{ endstream endobj 3 0 obj <>stream H D̾ endstream endobj 4 0 obj <>stream HWwNWݿs>NHAHD<T*BD yK$ e%J4Y˄FeTXCA+=SU ߙ3 V^7~ܳ>Py1w7a4?$ˀ4^_(5+ukxX3`̓{C֤fN`x<={̀ x3!ex43gl]9rpC}^));CW,> к| ZOYހTU_R.mSv 3[kQ~}ax쏄Xkٻ^f)s_uhp{cSu'Y`Ǩ iÑq'm4_!gQ-1Q8n_TƣD=48:aN؅˳e*jB{mo)q)||,&(St@w D}WבeWn 6vGX|%įRW:Z)%SAnxkl^i/핷f m6s8#(erHo6! ep-[c!XB G43̈́3LYθҚyvboK- c$r03)W0/\擧#fyhW0-Ћt<]Uځ=%βq]d 4Y&ŲGRMdu_N'clM8?#+0^n/i!m9KDuUoiu]/˜COnfY]|(, ɡdT?Vѯ׵Cu^)gS\5}M)u'y&yXȫ%̟TfD%`>@2_V`J98 @sGf-j&:*JE4(Rg%uW7l>җ b$d$OK,WXŹmZRn}yJ3TK9(Gũ!D!r5+Tvnt['z>/gr`3IsYyn|Mon֙îF0W+ӵඵVq޻-uZ7߅5$s:K/L<~rU th7hT0uPi_SVJ Xqd'rZ(Ĝw|sޗ2uD|WDuRi֩sTT^V) 1 3ϑo53ju?S5NJ?¥R'\_~=٢K WK[mn*t$VsK*Ap>#Ts-ZB;mLPZRzSMK(|zsZM)dmAVq}Q0I2uSad"XR-m-RScf2:տ,qzSQ dp2'ހY,cD7NYQ'O H2,ɹAN frܣsO< Q\!6bhG! v w݁NXd0 o]Bv RGs.x4csl<`bt:xlUJ,*lvjOB'Uo+4`e'5մVjZMk o-Fa[qfeRm=:r Jӝ.}O4D8"H`Qhb =VS ]L:}CI&fͥ#c3iQjv)>b6,`/a-tUxwtpQN/vXyWq:*鮪nG_8mɹ9&ff04n`dݻuҹSǰC۵ jӺU`1^,mי]I/)TzLR"ŲL J˂*V%[eB.چ9vnҢ@Q9hCRP6EPZc ͥЃCk[}+R%vgo޼yY&~tShZ辆H8 }^(`*ТIXd$=~.{e11WRɳ!Z]Kd HqJx~Z lˁO:`E_' oXsPC=)db1zƱBhX/v:-`bPZbSza\V'pLc,:"(l|yw!iMb[Z4]*֙X2*;by~}7WBQρ;|O/ BA|UᗥG'2j"aO6Zi[ UiӅ-zt 76Ŏe^?ijQ<ןnOQGK`_hkm]>Éعw}TsC%+~9-n?Fo7ˎA¸*ED*ZM@=U#npnWY_F70r`- #Z߼oU **y/6 An?3G^LgrW2g2 ގL" DM*$ *b2f3n"ch2 Bɔ GptT/}H*RG7wxң-Vcӱ4ւ"ku:97t` Gb.*VU BLm/`op}Kýo~<ښodț?$V;͞Xͷ?_yF қh#h^QDܿɮ(+>3{=|{;{{{-g b 4DvDm0DH+QN$T=pi HiC(ȑhTBSYmh r NQK 3{@i{36*Ldf@L4aኧ(m Nf5B(#Y+M}T*lOoR{gb6X zK 9SJ0$DΦe-vζ4)D7[3ZFd_Q7PU\Ua|H9lORKEhKZ<s88Ym`(];4GU|0v(q8DQS%`5D1h!ˈМFuF^H&Q!PUSZO"ԧq=`6rGs9!G`,fY3$c۾w_֜WG|gP\X'2[L9S 6e10aװhb0bB2P:1A@'^ `f8vl9 Ύ 7N  dG(_L>ׁ ЁW.? 0jvI~|o4\ 55֍:lc 1 \I= PЩmWM,Cn$PhNU"O.T!q8- u:b(l')Qg|Vse΂-nѽt /PaNQ2T ,yG9md5[9 -%;ΗZH$l-q -z$-:|~iv0Us}E?X8##M~"UpUiKy2?!a-udE"$VAhPmj%N.`ҿ錃;!p9~-SvL/k'SY:Oo{gNiN[[ mL¹@.8WU'*[Denj#i[Fe$0N'R!S"%XbϮt]C(82^jYzC94HxeX"嬬>Rh2&2]NҾNpQr4KpeMQnؘK@$VO\͉rAc ^3$%Aғzɓu̷=Ķ͛,߷BNǩˆc\{k(e{ê9]poi#|oi~٘K+|~YvD\ȴ_ s㏾=Wכ~X ?Y~\k"5 sbџQb2fh8#rqΈ*![j5' ÒUIlV7(J;f 9N/HmD fѶ6[$(ul8iCjv~ ^C 3?k`5`lAOfMTFVo mjxF 6;uz“yxGT`e =$#io7n7=H7E3݉)e ݋jRuN1XL5̝qy gc @,Ii_G*WDt9e%rf A 8ENs6Zz9VZY\H>5s=bOZcOi`~3nб1}j1RBH%]M\w;GlߏIhhij&m)$jF(MPjcm*V* !1U:$41m1G5LTw}9h{XfɊhY1*jq'ܔ{XۤiBʛ 6;/UlRR©QUAzazǛm+C0 ^ j~ P?7tp1Nm'H ; J-a>8ڸ߸8ws~3~3;||/N͗aAY)4=blgL7t u Q.@Q!ZZ(6WG˼`REIYl-lK+l-j5}6~3ۉ24oҹHvx6Kف@e:"jGD- Ak,bEJRb[XB@-=Hœp @i&&$)rC쇗b1W~<7 ڥ.5׃R3&y'5^ZJ,~]V7,_-nW7ognkrmiKٳOm-Pk'ca7|=vЊ@u@`~9c6UxO=YUT** >1(<UƟgm8;_ZgRݓ>ӑx8Չ `ݫxҖS~|7Xĕ|@_aΠ0q`@Ѐ Hm%gxd|/b9(w+ni7׾bmXc,٨oWcQxʾ 5B4#k8è D?yΓk2yUېбHzWwn`Tsy0`!hoR=L?x>x~Ůg+y׶ƃR 'J03 1o34s#$fx^xǽ3^G /7qgvvvo{{]q|Nn;DR"7UB )H56Q\^Xr(%"jdQI7sv!{ڝ~~P-͕2s͍eZʥ X**_yXpU-^!p;EJ2a%E11b~1{WF `__䌎8{Z*=1 j@<)$|+o74}o43|;8ŗȥҭ'cC!k8 > <4P QaCf[vM5j=gۋvT{/Ihiga}Nah9((GE4dS{*Wp]xWLc_15EGtZg!օPaU`KZ L n/A455&jZ0B@֥iY [ []Np!rm 02cRtb_#D'\cbf(}Kdw$OڍqHVTiMRPJKIZU˨H6Dてx!LENNk%}0[Pr~p]F_sZ;^:v+ReؗF$wNlޕ}t7?|ܾ޽q=K~ f;u_(,͏  J2@i=^*RY2Vza CH l(c`Zq|>ԐI"MG}F@95ZEatC? /1ۀ><4%g5F,2NxD`z,!L<}ш8VatP@~]jƿhRs?rѹLiX8a(Σ|`1YÉfM:+wkGdR1XwwM]CD ˽'C;*eȒǥE^z^~ʽ }轮yau#w~sLIxxH̵˝6nF##I4%/q=wAi`DW%ݻQشq" ATot߯? Ȓ@uל-,'"~rU2"Y1 ޸ K^ztS5ɑ`%Ҹ4/)U_UGRyj*VLdK5޺ }ٺTbrTj '@j z…s rwRD },&f)IgUeI\2)"{-w.drT9kled r!OG䣩]W|nO"LKĀr_WRXNMeSLڠ@#u{MʫoыK/\ZxCW}vw#ۘԆMN]/VH*kiB$5UĒZ%~F8~تQAU'湥x9Bj4LE eZZevA[(^&絋 z `yCXI,H#LM㚣(fо2UM׮H zRMCH%Ʒy<Τ٣(׵}iYkS\TR'˫dLc&cw\ܷ:YS]eFVc{lǞ;;qL<8q=N;n=idM?ن.VB,bC+!ЦiE*<"J`jrg7D{oc;Cq y `?,r}KmhqE HIllznOƨbq!6[mĸ>܌G ICht/rMFs[rf VO= c% 2.H[)t×Y C C޽4 qP ORt99dbޤHҨA֤\m]R/Y9hr#It#?pj@񠺼|W΍W)M+nf=Y~H~g\֌ey[܍B(`W]xb4cIHO\rJdFZ FY!(_}BxBn#MB<\E, `57 2ԷV/TlnᵇxE q5:;ZUx(yd"SlxRhHQcȠa 6`7/VHZ!7`=r\uPu뤘.FC]`٭_=baުoWu_C'yrH)Y]<,Bs\Ͳ'$ҭQj$a^UpG7y$5wo1ik|ٿTnٛeĔqyQgn;/Pf`{iHC!9| O" |o!P3(J>~htxEHp"@zA#rA! N#::crr;0&~u*%QK'+1\پ|YWgu%cVC?yR=ɼik)3$C0g|gLJ}$Q GԠ} YۯB IxArK;U:Wp>فʦNqc3YqT'9j#p3LZFT¥5;DuJAG_.&&q.:ǒ7&d{/ ye8l梔(K RzJct)hݰ>s*uee :[XJ Pz<{Jh0[pU|__yGuv IsU6ΊOp@*܃>M{=(rIiO4o*pN˜*eSveT!xg- Bj uWhg?ZǔUv):pPdȥXDejjxY<DܨUeG' 16u-#V- !6tFdXX&FH UU#C’ІD`U*5)iAcV*aNhn٬=[w_WJc-,4bK^ zk[͆J ZN\嘭bkCt)[zero-<糸rffYlHS+W WԢ!&[CNʞn׍ ,87'zst*_/.#Tq䛣;F4ZjFA8E+ HIy;[v?BF]9L@Pj؇sɈA O~?D묽?kTbiAou6dR$e|wzQAEQI8b Zm@,)8;uŽ DIşPVBp."'hmI$!@𧭚Xk[@-jh"AF^0ng~ګ ;(xe.[Ү lR{YNst)~QV SC00ǫo<ΌWܧ&f f3ƂdWaZHYg:їvW%ɩp,Vè$jfT.+USաLݗyvj%R~!ɤ^ҶzurSf2Da9^ou0I`Fəq'Dy2mi6EG/jW/{l/\fe,c8kZҼ*AJ6uf5;s idhygJjmv4\]4KTjO<((bLUaH|׷0` ©&=~ qL=8Z8xio8gŎ׺ZZ>ʺ+/OW$_mn'!2tI2S$t5+5I2Tje/S] x)-Ls*v:U+5I\}v6hўN)Y3ߪT׫q[s#P  ˀ6t7[iCfZ:o-^"yhخxÊԎ}VĀm-"uZih_OHl5,sR6{_L**.):t>0a4_23ْj:+ޒ5I>+j/a[H/k^%FBFyj/~Z_4u+fo)b.ntfog.n? &!Qg a)vC!L=uL/A0)U2zTs1p;E&)٥ou݃8/!0ڧj!52" lbDU"I4~{/W?{~w9)jbt?J;QvXWDdv9 <ψ Ⓒ"Njà^ld=yH*38y]?|rMND8[(~Å'r}B탁]BMpo3ħs30 LV@߭l@S0NiN9w?缠\\}R?87(Ϸ|pß~5뜶.}I.}ʢBK\ >3O'&׋5;<~ <"XLs]X6tAكʼnPS g Xod׺D` Ù^ lm`Q6h$h;4:G1@/p68ȏv{cC T=J\a jAA(};µXovTʼn h¬a'ͱ6 õ@w:t|+͓ay\r=H1c}?_>?qscq.QYz`` .;p̰ h wK`SG_Pk|duv0͙R_1.Vc;]m\uw>}󯻳c_I47[L ڠ-ڪ4Ch@'AD&@hHtdꁪuȂ[N٘ʄ6%6H{9OM]Y<Zrc9L|EQuƜ77uPaSs0,V mF}\α=3t+MNŨKhmܺ(n;E6v|ц znlj̋;#Qkתm2a9Pmy`wƕ#NrԱ4Z"8|;01x8}fWtH>$s[K{":L3:+"3ުQcWG'0BGоܖ/w9FR)8RⰫQ)EJ|5&:A$FtO4k#=lukN.ժ-<W]ʬTl*EK Mx;%?=.OSjN~iieKZZ潲O 7bs'*> $ùθƆߧ8 )ȀV SɌ|d“g?K]Ža8g*ЄsՄv>Г:ȺO j#dpd>!;R-3 y5MmrPJ,z'~K5-H0%H'5aL]$ʋ&L3ɚ㗻/}MjWw]ZKA}ªXZ,Q:8bG,[Ҡ_Đ'>믔Gք7nv ;7;ݚ]nF4A%%/$ 9t%88 B_Dq8t駉ǽܟ>? |w'7EXdEG>/lAzqЋƩ z+&V̷˧2|}ة@,w^X,^14KK'SXU eoR̢fekחVy{%h`w- nXeC!$&Y}|dlŇp^j^L᳙fXʰKڙKI`4xϛ F.QMjDTQSsΧrO#9T8K?>mσ<}xӫo|dʎ?9;}ڶk_E xu̗dКU.zA R 6M4H4K;AQ(K %+NWVմ\u5ϐBvT3"R l0-ƀfT_yg/H ki4BDIJ T ڤME۲ P?hU@ T2MZx޻t '>wz>PS)}}zXeiOS<ĚaFcwɳxw7#B/E631t8>8WuIBQˉDG@ MO};A!=f+BDp M)6>^|Oe3II9%QVP4P **(8>e5C!a2 ETEW1c<2/i.K]F+;ӜrR]Y#7hr\V.֡[o,7 8xYVJej$劺)6{Fymlؑ ,FA0xiYy=m"WM %BOX,دqxSQ" l)7Vfs2d0$[@džK0LÔorFLr[k֕Ug"| $mȱtKjps&Ur2H!PAt:z%n^u]AT]rk:;돲*ᤅ-?{Z+ڶLv&[$Ob¡iSus9Νp>$ZO(=`1z]EDZ=WB$:!UeʜϜ@F#A`ٽ==ĞC2g=%,=W *jO޷91P#Y<*>*MgˏgyqN>)͑9df2F;BRBx̀~ČzȮj(ǴxAѴoL(ϧ]ua9l[)۶ %9r))exAYIɲb%ETa iR%%"X(: НUb/q 7[.[~?$]KIn7[P9r@]0TBIְ ,v1w0]NuU Vב{]+`Q7?1! ll}^ٌDsǶq29MڦRa|-VхbBA^3Fw 1=cj">iL 3ȳKA<}kfz _ڧko.~zֿ( _ώebAB6'!}#0 7( D uw֨M#TCp:<ȥZR 2izRiDyp&vxo>6/Mf;Ort?)|0Np;bG5:V9=ڸzmVIfFgL'̂ -q)^-Py;Sobwtx eF(}gM!>-i^hK 7@˙tl6]^F`lF1n|.acO+L)P/Bը}lfci0C)$$6F4hDae.iDFMQV9C`N0 D+S鷡4-G^~:Yű%] =ETtO]%DwкQ1;cOP7oj*m{ތdzq}9ە矈´sWn^9c3Ws'mY[Ro+ٝ7Uԇ\C%ԟ K\N +`rl-0V1\:6CȗNYD_Gq\s)>-/p񯕥8NhOzD?Nv^3:YbQd%Ç2Cz* LTXQaNMOPݘ>9KPY|JKS)vt⻵ӬrxuQpƼTӴl.sdHivOfN<2TS|ݹM 3zke18pճ9I B)F Ķ[w7&RneechN))ٓ,n'De3B̜=2:s, AOޕ2;QD-ͣ)_sx OŦƣOʭSĺNQ(~>,1^K[k[h=+6Ѥ_MJ)=ߊ)_V#߳?r=l?\tT##2t]G/?Cҙ3$验Du C<@:tU+ qU")v7%Xmڌy[Bhs=uuf5^^Vܻ]T٘q[)y+ߨ+_^i9inu-bpn𽛹t>=So"z\c0 Si .cNj!:<1姃x<= ^GuUrJKks&l@祤ɓ}NW!%&ݑZ[<1nNT̮1rf}*Hk'Ex^%w783]N_| "_QBN̩Q°+>%+wt+dP$)=gvqB~]8b[nj,⥾rn%̤{ ќnYm$IovG*b|ў{H'=ӝm_Q_%J|SȒlԣ%^r4!a1(?oA$s@XTh{1aC9@+YҵT̅\~BuVCo׬Ĩrj1=k]z햣Vz]JQ8y5:@w|!i@1˦4>h_5E}2żrn1kR3rK) }Jx߼g{O~^C07 ZkqxZiw^_iur#@ y."Θu kOS uہБBKB{9@Au(܏"{@hx`67X3BOBglX6Kyhouh+̶cn،dA/>Yps dõJVViYmf{=lF*{>Q~L&zB%E6аCҸKWsHz, *xHR$M><R1- hjC!I@(?Թ ktڹtM;jӲԦSZ&.eY݀"E2zG-shoգ:e]labM߄]a5gjYg^ʭ19NOTx.ĖbN'ȱ/raOϡ~w.mS^>V ԩ ŀ /,4QIЇxe~ d_ЅoܕHiW{Nhb ǏP ]4ȯd$Do#_8, y:YlvdhoS+Ohˤܺ* ?-PR?{}ITj0I1Q4!hJJq2-BLQJ; NPV:j :Z)vm&o9{&{IFع"SSJwHrr_\lYK:1|ڮ~g`\ۏ6A %lo<xi{ܐzleLК[&nqyn3XT'X۰B 7n w<fQBԇfl" 4>9¥2$s GQ_AD9=8EFbW?+zv5?o7>BnNN޾X Rg'{Et͓rU6ɼ\}еf%D{H ^f%=/4j=8g9!oitwWAȗgW6b>k:z$ؑz셮lmMd]Kzk8_ϕ* QeZ89[ȩL^uW;_2 VaW` 5Y yǮ "+1WE};?1:䏎kw߷eֱBx;)_}YX js⼑Üm!:ĞbGʃ5aU⹄\\(iqlciǻ)rxǼc8[IWԹb=S&e]$]ѻE[>$qysehZ.āX 3ʡ9`L^5z !|+NvcA_9oU[}Ț8_JW(zd"z .1Ѐ} r5l\BXm> *A\Y!ΟX.mZx\쓺K"P/c*'vh:sUPtyI &ac{r}ALy>Fu`i (w=}vvtMB;6\@?| ut;[ RG4t)~_EǶ ۤ%&ˈeHT'37ѱwIL5?~#V_ٚ/Aj;< T} {!B[p{.([.ڙ{aY g<@E\P]>TMp1H&ں$ԫN˒PvJGvW?2 #ƭJB}Q#:HBq~OA| <˽طDuFd~_kܨGp1t}n[N+G}OEs[ܜos %έoVj 7*QwhmUWbo^ !iwv|"HEnIJiz -|}ޓBߣޓ*_-xC d qzZfi 5bNkyJio4VKToCWJ%'{8lr2+s6bgX;Wo&76̆%|7R2ӝ]ۛYߙf7Q׺ #{#̏axNemu|ҋIr#3rp'AǙEzXGaj;kξKtiHn]կv%uv˝Ε(ԭ-eUu a&"h4lIR$(H"Km]ZUaZEPۢ%ZlEaT"2t,mQDYttѺTZ}EҎ~39z$T+lA=9ǘ6Yb<2DS.pPV版J]cya|(5v O2Dر?'"@uI=Yd]y'My5= wƭg0*,z83^Ǣ~?q^ܥt:2ǒ wj$-PCjzdX.%7'^4YnIm>okGfLd?]yɥMg+Ue~`yi`^85rЬTRm]?k:*G}eG= =r eW7tQ] +mqe >سVֹ̜jywW^Brg_w[P}j-f9*Gio%)H!od껮] NOVV{>2֏CmiYOwr$5G֯(Sڨu^ /Yf}/Jݞ3]OEH~E-W]%27?|a,qP?ߕv}Nx~srPR勲4|]zC+Cn pco+VJ]^̶>Uo?NuXKf.pTwmگUquD/[M=a^ ż4ooJUT9>y??5<nTqiwެGľI,JYJ̒!dDܻH9%?";̱"s(|f!Q_%/r,xĭW]%ϔ1 Hipy'OKbވbZm{ʌ7lLQi\8c|+lJMj/$^fTA]vKwl~j8  Z.yY%uޓ NrepWȱry^/E28;/2?1!/J>gp_GiCewM)'ߍ1eޱa/ nE_'M ߖ0QV13Ӽ+G'OsF_ ) ۷tV?vyj)I^毒US-uZΤ]?;vղWf:/ᔫ: e&:(M j ~n,2|0cL $j<{*9Ia<|Iso%(3G='[׷cg]!ꘟu뛶?Cϳ`&Ƕ-lCCf3.]iJa==F'^4{LJ&4/ب+}`zySY#KxQ0Z J(XP $*Qx)MbBim*'ZURׅڈTMjv;93s=sEo:}gY~gHi%wr~X_d#6P~vLj7Z~zhqXF⺌%E󡾔cع~)A쯏n5nWtw N_c;<uMR`:#)I<6|kлQ삶 CX$:&O=o}MVd+dU10 u3psxck^rms ǭꞳsFm-Sbc2 5Ldd,I%Ey͙'|oS]A }g0щx }4b%̟%m|I\qMRI>IʋSqQ @:Ǔ0Y-|Lr> ̮g+ , %7spgYU{cn?*/%灍 O BP( BP( BP( BP( BP( BP( BP( BRр2}%A\۟`gH)ɔvb'Kyxײ&k-FȲWYMd HwZd}e [v~ٲ98~aGd S#ҁjza75  񮚨h7Ka0k郎3kVF7PAˬ}H-0R:2ֆEPEFx͙gT7HKְH5Vi)0BMMFUֆv*n+0V!"bVUlVf(M[C=AXW/).GRWŠ%j(IlWMbG I3 2ۻ) I$6iK)NmdQ?'%t?,Kk_8YO>ʲ߲;]D{tƸAuN)5G4W99]]35Mvq8s].3[tN'tNL좝kDp9r oP"}$vqs8b[tlklax]s>6%N)!QnDdKeݰ Ko8׬=,DG*eK*&*B0׭wn[VL^~v[+fąW}5%}b<)="6m Hj8/5FA B b(}n$@*I YR1iɸ=GWʙjH/컟~v0(GLU(OXG;w)} xb~~_0q"_).Oȣ&i'My̔M0eV04Ҥv:R+nRݝ@uiigbB AnԂѴ&c!1 fB>  FyQ $ZϽ[A^L}s9޻3.Fx+uqKN*3I'ܛT =(nE m Vm\Wƕqݸr0<V±PZ2E|C W[2Q$Di'JR'1TG)QWfv+ȆL7%e1‹7'nq2c$y7 wh_h 0$2oa[տzٸq.{O BշP-`U{Ox訯 >r<8!3ٺTA8ടlZ;}m-:y^V[d=XHcC:e8& k!0_$g8$?vCGOoDk,wd!Q p.Q7-g0Dc UMmmySO'4vVste a˄bV٨=I6{}wOO e:15K5 YkWnqJqP-n7mbŕbT#EeRT%I $NBRmy@pk%!@1#E? ~9,qpzxsRثq3NY\7O}$SUzbآuΫ!RG#.vrc޵>XI=^PKEъ:5o%4nOy'ԩ뵲Ev-}9 7QJnf?L~ޔ!2)Q4R xɶ2W5mT" wSϘhJ@^J V[Ee1*NVp% W#l%t$ JJ:Jz; O kze:.YƷ4 l% '?P?}j!SޡX <~uv0wA}+ fP.3SYC?` ۝tnZcwH6FuZ OZZ$Ha7SP[iNclG;@ ׫RFCMɦ$ !e/mם/"^OX4}ZBV7"ْ{ 1=*묈(D $$ل>(r~] ߁v,<!4M|S:z5/ionY׺ >stream H\݊0}\IZ-b>ձ+1·ߘSdfΉǰ>stream hބRn0=( ) 1b 1h%qiO>4D"AP 0€(¿>(Clm]sjtu8[?J'#f l4Qq97LR8׌1ÕV*5<oh!8 pCe"tHCD}BSE@U"4S TtO tRDK̍2w5P 7J䫡q*bQ^=|prz/V]}WOBYI endstream endobj 7 0 obj <>stream hRN0QeljD"QG!4NB=ޭabg3;^/gb:fPΌt~suXM W{keMհTmyI +pKO̲ky2?&gn<~Ѻ7&)"Q U>u:u-T94sѪ C p$)Qq \~jo VWã',H$"GEI$焧3" >stream hބ[O1yĸvCHx!PВ%⯷ I73;3RrPh^}`5:#iSNPgХHZ4"n+V{JJ?F͚ 9 JZiܑN:i?VGyGo5z9T`NKtn-oiF-_^^=&׶g؊^}*n "SE9M\;-$JiSjZ.m3n mఈ?ED]fVuHǕ,XAl҈&e{>"mfPg;xE+${w#;5v2 omtGd endstream endobj 9 0 obj <>stream h|n0 _O06q@Q [=,kshhVlӏϧ]Hb\~,rUܔEyS,ʲO"|%{hB5(Ў;>stream hXo9O#<k{SBZ+U OUBFM6Y;n7^t'2x7x\/!E0RXC(aF Bik1BYB9 tZ/F ! + *IX-TTVXEIh)102kV(A8 pJhRkH8ڀǁπǁπǁu;9 =|^zV >I`:|G:j-<"Ƚ$e$B2J"/dRZƺAbi `!l#RЃ>x#td>BHD>Dl[ $MFy%EGP#|/$(; '; .; : : 2;G)wCEQwáW Uc"kl5`5`v5`v5`5`5`5`,`' 3+Eb%%Q+\8RA)V{BaN(3%J9(+8pA_Y:k>75]}+tu\V|vUWgzsNYy@pYtwF!3WF'V J"(:b"ptR&[*K%eiY,3 Yf>L6y' k&MmM^mx$Kv.Ku%;\wO,>O,>;YuV_Do~;;pdl7w4vΗMu5ẝ=lhy1_^g[jmfnͺ0n^^V uu?QVFożnf(iYr67]竻^W|Dm-OUc:88XN6"İH8v7Vj=aVaR9?l=<=ȿVlw7xMFBVgW|:{"BqPH]bً|CjI]1#CBnHž?Z^nEX'`FzĶ_i=b?&`lLJݔK~a.гz@>nzjܢwWqΉXvNfwnG-c6[ٍ;gaX؞Ş)UTRnJq4<8;<)]Mi;nJ}y/z9\O|gL1K_0:ۣsK)WWP]T[q]_릭/wq{MsG`[|W{1'ۯn[77<<< endstream endobj 11 0 obj <>stream 2021-10-14T10:55:04-07:00 2019-07-15T11:39:50-07:00 2021-10-14T10:55:04-07:00 Acrobat PDFMaker 15 for Word uuid:e8060e46-d8b4-4269-90a5-a5171e56f7b6 uuid:7c84f580-0a35-4ad9-b2a1-4275b22d3a37 3 application/pdf Prior Authorization for Stage 3 Bariatric Services Request Form - UnitedHealthcare Community Plan of Washington Brand, Marci This prior authorization requirement is another step we are taking in support of the Triple Aim to improve care experiences, outcomes and total cost of care for UnitedHealthcare Community Plan members. After completing the pre-surgery phase, stage 2, for bariatric services, please complete all fields in this form for stage 3, the bariatric surgery and submit your request online using our Prior Authorization and Notification tool on Link with all relevant clinical records indicating that the member has completed the required six month pre- surgery, stage 2. Adobe PDF Library 15.0 D:20190715183811 UnitedHealth Group D:20160209 D:20190708 endstream endobj 12 0 obj <>stream h246S0Pw/+Q0L)641)XʂTb;;9 U endstream endobj 13 0 obj <>stream hބRn1~Jz!H(!TP咋;ˮ{IwlDJ7d1OgY<4EN/9v~;JG(ؙi[̹sjL8ep:=1⶝[3E6#A6%xT$t~% $&I|e"h$.KE cg#ElC Go8 'YM wAMhw +4xDwy A{m -y)XK[UMHBxe+ OzY.u*qU , ȁ";S.+[A7䒴8GX,,}, `/W7sW`Ѡ5y=9h+qih,c2߭ թ-y6{xa9)PQ^mW0`3כ(6sfߡg1I־οHSV'SǪ5~<{_E+$p-N endstream endobj 14 0 obj <>/Filter/FlateDecode/ID[<4BD85A203F5CE1408F4A9D6D5F361FAA><028A43E61C88D546B6E7053926257155>]/Info 137 0 R/Length 104/Root 139 0 R/Size 138/Type/XRef/W[1 3 1]>>stream hbb&F@)&F)V"AdX$dLr` XdcB*ef" 6;JRI/"i(9I`$ endstream endobj startxref 116 %%EOF 1 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 1/Tabs/S/Type/Page>> endobj 11 0 obj <>stream 2021-10-14T10:56:09-07:00 2019-07-15T11:39:50-07:00 2021-10-14T10:56:09-07:00 Acrobat PDFMaker 15 for Word uuid:e8060e46-d8b4-4269-90a5-a5171e56f7b6 uuid:82fa4ead-9e97-4b86-8e02-ab76f1fb9e33 3 application/pdf Prior Authorization for Stage 3 Bariatric Services Request Form - UnitedHealthcare Community Plan of Washington Brand, Marci This prior authorization requirement is another step we are taking in support of the Triple Aim to improve care experiences, outcomes and total cost of care for UnitedHealthcare Community Plan members. After completing the pre-surgery phase, stage 2, for bariatric services, please complete all fields in this form for stage 3, the bariatric surgery and submit your request online using our Prior Authorization and Notification tool on Link with all relevant clinical records indicating that the member has completed the required six month pre- surgery, stage 2. Adobe PDF Library 15.0 D:20190715183811 UnitedHealth Group D:20160209 D:20190708 endstream endobj 140 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 170 0 obj <>stream HWnH}W4/"6 "1>,@ˎ-y,)~M}HL/:uΩzjTj6;>=QGo׏۫rwfu.Ǜns~o _֙ZY]oj|a( _7}==f[=~/o׋flC[Qm|^,ҨRMҺ(,5]d/|bZeO[B{G9 /.ܩlW/y[V:Қ6_EZel0p\{= u#ieyqf˜oa k>_^AIOX@^pLZ֫ A$kz\][ˠ6hNG]ihL&ObjYM[HŃ\!pI4=1V+?i +?tY|,-go?1;?QNd5Ksh6n1yu1kUafטt_a~NbQ>ZG/@0j{p;+'`_)C| ,AM@I3p:ƛhOs(SI/02C`My~7~*OcHxS"U=ymq4* fBS Qxp:(ܰ} 껱ZRs(smjKpJޒQFPςM.4M,_A 0~vKۍo8sp|Apx?:XF>c lj;qx:NO8pnA=Fz6wrz&:jhq-EN-h:B&b3, yT8z"zF"ؾ_jy򏜼;DhQ+HE#QA*QuX݇AQ"/W<}(Dp/?7O]Gjv(4U80bW Қa HtMH#gn3Т<@F:7di`F" O>H&Ǩ$̦Tqg5C3xl`حP˕Z3;rAxPhe]l,< ֒M,HQÀMmouD;dď;ԍŝ8AO;W !7w~Yd`:T3Pt+.79Yҋ^"L9Iv kk?ZBȄZ~Web!=nw13r l[ gġA]d'Zh,V9͘h0-؄&M<Wa@%e`Δ]Rg=2`Cѕ<7,۬x90_O,9w޶HsgM@Uh!W[I\6SbJtP6>ڊsv춁; "؆,A 0[MB^V:byذBTaZjBSM@US 8g1‘3t79?ju]TVb&#\UT2ƺ,̾y(&߂_YAAkG\GA_] "5Z<$;>w2rM+ sl`<粮h[l 5ʇLLCpIcv8힅ufiIPTvZ)+nЎv?w^QwI^*e>_kDr@j׬Aes},gFNv7̃^՚Y9IM㕤ds}&?!YcbuVC:LflN^Hwf@XͶ4T9"4e@SH`W!nM R =;anct*W-vr?sN/deL~-a"鳞nUp!K)zt<0t?݋i:؄POLƟg8H]/~}IF63%}O.!oj:yiYռ)w=GeB]N1r*Dxk2ڥlp|1ܪ*+.Ghtq)e+A>mrԣ\խh5IJLiy눷sb5`zg4޾u'à\tz/M-Xa޲Ÿ`:lFzŇ~3DSK dH Ɵ>\Wm6At،S2q_  endstream endobj 171 0 obj <>stream HW[oF~G(IAI.QXx-QZT,ʎ\р5˹_31oN?]Dݻ'7߬E?}X7Ks;{0Oo消4KJaR$0-dYXU>]c?w]<霾nM[$clS=^bj.023_ 36qV2L,1˛ san.7,OAe.A=rĩqO6"65v=ygF :W|'BgJa>E&Cp~ ~"B#R}Yť ;SNp ~8ˑ?`B*} &4!tM3<\>V\EBAr˜/iIe&|6(n &;/ 7?^I݈6hWo薧=S;!s~LVig PBpFhDNm N7 c2.MFe^@T2_0fzi4iK45Z*QNgM<r8~ONA<}l#ܣ-(oIB'"LGB'7σ\HNPO=C%dv +0o$P?m:"e#\n*$JߏU⽩[<&7@;:^Y*F^mB=$m>alm+F {~l,t䵞 \uk)iHECb:$Κu]w w,B^>pT܈"QjD9GWjZ}ΞSP,dsHCpos:٩6>jlIxi+>{?OABẻ Cbv"| ȃ%vJ}}A{kbQrԔA{zٹB v "xAqP%*}  @'ȵdCLՄ3r fRpɤSٙ@6fk9x8$PSU^İdEl uVb)mXy eʂ6fp< l{~r4ِGF8ʂ?%tBGiᅝ[ZrFʨ ڵMJέC,Sّe%RʂX6,~EںQ; \8WR\ T=1 ˡըzp (^^5BeqQBdܲ )BwJnRSd0x1F=99V;}F4GR(FHP Հ霖v7 K) T!ȣݛ``AB{G OߏXŭ!9L%1R[{[Nhdnl9)Fl r@ZƂ,hz$ߋkry5 1JacÊoc ,:έfG`ݭ M"@ /mq|H˕2:0H,-E^+sb߂JۆZ [Myh,luPRyQZJ=fig!\o+X:1QW }t B3.yibl2LgZv t4F*ۡ,%OɨM}?| tOBN=T£rCgĕϦ ˤֶ &3.Oڻaϊ|tm.>/7_ޛy=n, G0dUaVP{"38F 3 \PNl@%gɛZqZjVܳ9;BEX06N8[ 20NzHY"}Ee8N󘟜nX7'- xtѝ/O:kk7=C[=`BEkI9vǁKoJ,&9?ȑdv gvZ WBDnR4Dž)R7JA$&.SD9r"}Cu3~LU'b-@3+P'quO36vm_-S> znm Ymj&bS½M@~I3Â:÷hA#;(mv4)蹨؆QXEщW)BUHRh7/R(qB}cvj#&IND$MlD8{A:v\CHVAyp*]BۙA§ΎWв\o3i)|xlm!0 Ad=IX3c;em8R,MLovPlm4,xz<XqcxZ gSΖ f7b pOaNV:Ywk/EFylK|Ž~NRƪfQ;FFI ږ1{ Q"._iN̩̓ 5btb!0j}G'X1jmpߍu`uCddA~mً +S-ja[aFt! ubjg,i?tAHXr_M@P8'*`&]\2 ȿgꔓZlɧ>*v #?T}I\k3I|p;Q<93AO+O>b&buo&E:1!̹Ya{Ne?y -657=59d LG]b9MH6 jNr|xf5])?+tltџ:u/>wx7הj"3luεOGFp"030`[N >jH:Z7+PN&EFvs {V@@gPr ]Uh4/_J|T7jz%bǭ.oIL+δw/42?)P Cjt?DB6;j>Zs:g)OH/WVo endstream endobj 172 0 obj <>stream hބRn@üK\PTQ$R!TP%/ػ욄|}gTs9s.& ~0o|aH]XJR:|U-ͱh7/+٦bgy(;1YpԘI:Nl,zbr+m;ŷl&=OKGt [Kb)O?֭5)o /[<<`GO endstream endobj 173 0 obj <>/Filter/FlateDecode/ID[<4BD85A203F5CE1408F4A9D6D5F361FAA><7D680B6C5DEFE04ABA3625B3E33B9B0A>]/Index[1 1 11 1 137 1 140 1 170 4]/Info 137 0 R/Length 44/Prev 116/Root 139 0 R/Size 174/Type/XRef/W[1 3 0]>>stream hbbd`b``dbњ?R2$D@`0~4 endstream endobj startxref 84388 %%EOF 11 0 obj <>stream 2021-10-19T11:11:29-05:00 2019-07-15T11:39:50-07:00 2021-10-19T11:11:29-05:00 Acrobat PDFMaker 15 for Word uuid:e8060e46-d8b4-4269-90a5-a5171e56f7b6 uuid:a42fc83a-b666-d14d-a9b0-5f3b10dd4ac5 3 application/pdf Prior Authorization for Stage 3 Bariatric Services Request Form - UnitedHealthcare Community Plan of Washington Brand, Marci This prior authorization requirement is another step we are taking in support of the Triple Aim to improve care experiences, outcomes and total cost of care for UnitedHealthcare Community Plan members. After completing the pre-surgery phase, stage 2, for bariatric services, please complete all fields in this form for stage 3, the bariatric surgery and submit your request online using our Prior Authorization and Notification tool on Link with all relevant clinical records indicating that the member has completed the required six month pre- surgery, stage 2. Adobe PDF Library 15.0 D:20190715183811 UnitedHealth Group D:20160209 D:20190708 endstream endobj 174 0 obj <> endobj 175 0 obj <>/Filter/FlateDecode/ID[<4BD85A203F5CE1408F4A9D6D5F361FAA><9C7F0771AC934C79B812F93DB2ED9C61>]/Index[11 1 174 2]/Info 174 0 R/Length 24/Prev 84388/Root 139 0 R/Size 176/Type/XRef/W[1 3 0]>>stream hbbdf`b` $X endstream endobj startxref 90484 %%EOF