This form authorizes treatment for athletes and students of a college and university and provides important information to hospitals, clinics and attending physicians. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Philadelphia Pennsylvania Identification of Insurance for College or University and Authorization
Category:
State:
Multi-State
County:
Philadelphia
Control #:
US-02397BG
Format:
Word;
PDF;
Rich Text
Instant download
Description
Free preview
How to fill out Philadelphia Pennsylvania Identification Of Insurance For College Or University And Authorization?
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