Alternate Authorized Representative Form (Output)

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The Alternate Authorized Representative Form (Output) allows the user to print an alternate authorized representative form at a Clinic. The form is generated when the OK button is clicked on the Generate Alternate Authorized Representative Form screen

Data Elements

There are no data elements on this form. It is a defined form that can be printed at the agency in the event that standard forms are not available.

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Software Version: 2.40.00

Clinic