Reviewing Forms at Beginning of Survey

2710 - Reviewing Forms at Beginning of Survey (Rev. 1, 05-21-04) Request to Establish Eligibility One of the purposes of the “Request to Establish Eligibility” (or the equivalent application form such as Form CMS-671, Form CMS-3070G, or Form CMS-1572) is to obtain and maintain statistical information. At each resurvey, the provider or supplier completes the appropriate request to update the one completed at the previous survey. If the form does not contain a specific field to indicate initial survey or a resurvey, enter the word “Resurvey” on the upper right corner of the form.