/
Rev 12/2012 Please return this completed section to the subscriber who Rev 12/2012 Please return this completed section to the subscriber who

Rev 12/2012 Please return this completed section to the subscriber who - PDF document

cheryl-pisano
cheryl-pisano . @cheryl-pisano
Follow
402 views
Uploaded On 2015-08-12

Rev 12/2012 Please return this completed section to the subscriber who - PPT Presentation

that verifies your authority to act on behalf of the child eg guardianship papers or power of attorney The physician may request to see the Authorized Representative Form before completing Secti ID: 106143

that verifies your authority

Share:

Link:

Embed:

Download Presentation from below link

Download Pdf The PPT/PDF document "Rev 12/2012 Please return this completed..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript