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  Please complete this form if you believe that fraud and/or abuse may have occurred to you or a family member. Any individual, entity or group that is employed by or provides service on behalf of Family Care (including employees, subscribers, professional providers, employees of a provider, facilities or billing companies) may be the subject of the complaint. If you have any questions or concerns, please call us at (800) 853-9594. You may submit the completed form by mail to: Family Care, Attn: Mr. Sam Hamadeh, Director of Quality Assurance, 11111 Richmond Ave., Suite 200, Houston, TX 77082, or via fax to 713-414-4953, or online by clicking "DONE" at the end of the form. If at any time you require assistance please call (800) 853-9594.

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