A Medicaid-covered health service. Trip 5 Trip 4 Trip 3 Trip 2 Zip Date of Birth Trip 1 Mail or fax completed form no later than 60 days from the date of the appointment to MTM Attention Trip Logs 16 Hawk Ridge Drive Lake St. Louis MO 63367 Toll-free Fax 1-888-513-1610 Trip Log- Revised May 10 2012. Trip Log Call 1-855-687-4786 toll-free First Name Facts about the passenger Last Name Medicaid Address Phone City State Name the driver How is driver related to passenger Self Other Trip Number...
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What's up everyone welcome to mothertruckin monday we're continuing the tripfrom Kansas over to Stockton Californiawith the wrecked wriggle on the backhere its owner oversized trailer thoughit's really not oversized but still gotto deal with the trailer with I gotabout 12 hours to the delivery point Ibelieve that's what it was yeah justabout 12 hours well well yeah probablyhave to take a rest also well anywaylet's get this thinghopefully you guys called the the updatevideo for the advanced simulationproduct game controller box if youdidn't I will have a link at the end ofthe video and also the littlelittle cart that pops out click thattowards the end of the video to go aheadand check it outI'm pretty excited about it lookingforward to the actual release of itBeckham I'm actually looking forward totheeven the pre order part of it gettingready to ship all the all the the toKickstarter projects out just a fewthings wrap up on that such as likelabeling for the box that's going toship in I'm going to wrap up some thingson the black boxand way they will goif you did miss the the update video didmention in there and i'll mention ithere it would be a good idea if youaren't interested in purchasing the boxit would be a good idea for you to gosign up at the website it's a SP Depotpc gaming calm and go over there andsign up for the for the email list thatis how i will be announcing the hell ihad this earlier wall coming out to themiddle routeanyway I will be announcing the openingof pre-orders via that list and no otherway so just kind of a little bit of areward for taking the time to sign upand stay informed on any kind of newproducts and special offersso anyway enough of that I alreadytalked about in the update video we aresomewhere in Arizona I did drive alittle bit before started recording so icould cut it down because it was like 26hours of a trip and it was nighttime soI just kind of wanted to get out herewith some daylight get the trim cut downandas we all know and I am not that greatapart from these thingsalso if you're new to the channelwelcome Full Tilt did a thank you videofor me helping him out in the past whichits kind of stunned and surprised thathe did put it out he did say somethingabout doing it but told him not to worryabout it it's no big deal became himwith him for 10 yearsbut he did it and a lot of a lot of hisviewers came over and subscribe so I doappreciate that too full tilt and theand the viewers that decide to come overhim subscribe to me fair warning I havebeen very very busy with the ASP projectgetting everything going so I haven'tbeen putting out as many videos as Iused to in the past but right now I'vebeen doing the mother trucking mondaysthis might be the 33rd maybethrowing some quick peaks here and thereof different games I have tons and tonsof games that having even got that lookat yet...