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Medical form and liability waiver for Bellevue College Summer Camp participants, covering medical consent and emergency authorization for minors.
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New Patient Intake Form
PDF template
Comprehensive medical form for collecting new patient information, including personal details, contact information, medical history, and healthcare connections.
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New Patient Intake Form
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Comprehensive medical intake form for capturing patient personal, contact, and medical history information for dental practice.
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2020May Youth Participant Waiver
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Legal release of liability and assumption of risks for youth soccer program participation in British Columbia.
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UC Davis C STEM Center MEDIA RELEASE FORM
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A legal document allowing UC Davis C-STEM Center to use participant's media and likeness for promotional and educational purposes.
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MINOR MEDICAL RELEASE FORM
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Medical release and contact information form for minors participating in the Summit Music Festival seminar program and concert series.
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2020 States 4 H OB Medical Form (Non Japan)
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Medical evaluation form for 4-H international exchange program delegates to assess health and fitness for cross-cultural exchange.
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Veterinary Student Interview Sign Up
PDF template
A professional networking opportunity for veterinarians to interview 4th year veterinary students for potential employment at their practices.
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Physical Therapy Of Boulder Patient Intake Form
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Comprehensive medical intake form for physical therapy patients covering personal information, insurance details, and consent for treatment.
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USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
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Medical release and consent form for youth and junior volleyball players participating in USAV sanctioned competitions and practices.
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USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
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Medical release and emergency contact form for youth and junior volleyball players participating in USAV sanctioned competitions and practices.
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Shenandoah Outdoor Adventure Recreation Health And Medical Form
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Comprehensive health form for participants in Shenandoah University outdoor and adventure recreation programs, collecting medical history and emergency contact information.
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Wheelchair Initial Evaluation Form
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A comprehensive medical form for evaluating a patient's need and suitability for a wheelchair, including medical and functional assessments.
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Boletn De Oportunidades De Cooperacin TIC
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A bulletin highlighting international technology cooperation opportunities and partnership requests across various technological domains.
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Consent And Service Agreement
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A comprehensive document outlining consent and service terms for counseling and therapy services provided by MERCI Memphis Counseling Center.
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MEDICAL HISTORY FORM
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Comprehensive medical history form collecting details about patient's allergies, environmental sensitivities, and dermatologic conditions.
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Annual Pre Participation Physical Evaluation
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A comprehensive health screening form for student-athletes to assess medical eligibility for sports participation during the 2021-22 school year.
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Student Information Waiver Form 2021 2022
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A comprehensive form for student registration and information collection for a band program, including contact details, emergency information, and authorization for information release.
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Emergency Medical Form
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Comprehensive medical information and emergency contact form for school students with parent and emergency contact details.
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WILDERNESS ADVENTURES ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREEMENT
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Legal document outlining risks, liability release, and participant agreement for Wilderness Adventures outdoor programs.
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POGS Sickness Benefit Application Form
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Application form for members of the Philippine Obstetrical and Gynecological Society to claim sickness benefits
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Warranty Claim Form
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Form for submitting warranty claims for prosthetic products and detailing product and patient information.
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Consent Agreement Form
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A consent form allowing the Securities and Exchange Commission to collect, use, and process personal information under privacy and corporate guidelines.
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Motion PicturePhotograph Release Form
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Legal document granting the City of Los Angeles Economic & Workforce Development Department rights to use an individual's image, likeness, and comments for promotional purposes.
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MEDIA RELEASE FORM
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Legal document granting permission for photography and media usage for the Euro Challenge educational program.
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LHA Trust Funds Grant Application Form
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Grant application form for LHA Trust Funds members seeking funding for healthcare-related projects, with a maximum award of $25,000.
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Idaho Health Examination And Consent Form
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Required medical examination form for Idaho high school students participating in interscholastic athletics in 9th and 11th grades.
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King Hall Outreach Program Recommendation Waiver Form
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A confidential form for applicants to waive access rights to letters of recommendation for the King Hall Outreach Program.
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2021 Maximum Per Unit Total Development Cost Waiver Form
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Form for requesting a waiver for maximum per unit total development costs for housing projects in Georgia.
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LISEF Media Release Form 2021
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A media release form for students participating in LISEF event, granting permission for photography and media usage.
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Employee Medical Inquiry Form
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Medical form for employees requesting workplace accommodations, to be completed by both employee and healthcare provider to assess disability and potential workplace adaptations.
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2021 States 4 H OB Medical Form (Non Japan)
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Medical history and health assessment form for participants in a cross-cultural youth exchange program.
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Wilderness Activities Release Agreement
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A comprehensive release and assumption of risk document for wilderness activities with OnTop Mountaineering, covering various outdoor sports and potential hazards.
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Cardiology Medical History Form
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Comprehensive medical history form for cardiology patients to document health conditions, medications, and allergies.
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Permission To Participate Medical Treatment Consent And Release, Waiver, And Indemnity Agreement
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A comprehensive form granting permission for a child to participate in church activities and providing medical treatment consent and liability release.
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Rental Agreement Form
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A rental agreement form for ski and snowboard equipment rental at Mohawk Mountain, including personal information, equipment details, and liability waiver.
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YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
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A medical release form for youth and junior volleyball players to document health information and parental consent for participation.
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Via West Participant Application
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Registration packet for participants with required forms for camp enrollment in 2021.
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Walker Waiver Form
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Waiver form for participants in an ALS of Michigan walking event, releasing organizers from liability and granting media usage permissions.
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Course Waiver Request
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A form used by students to request a waiver for course prerequisites or corequisites at Florida Institute of Technology.
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Patient Intake Form
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Comprehensive patient registration and consent form for physical therapy services with contact, insurance, and treatment agreement details.
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Safety Inspection Form
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A standardized form for conducting safety inspections with spaces to document inspection details, findings, and follow-up actions.
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Release And Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
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Legal document releasing 3Point0 Studio T from liability for potential injuries or damages during participation in activities.
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Data Protection Consent Form For Providing Comments On The Preliminary Assessment Of The Financial S
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A consent form for jurisdictions to review and provide comments on the preliminary assessment of the Financial Secrecy Index 2022 research project.
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Patient Intake And Consent Form
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Comprehensive patient registration form for physical therapy services, including contact information, insurance details, and treatment consent.
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ParentGuardian Consent And Medical Release Form For 2022 23 JSMC Youth And Junior Youth Events
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A consent form for parents/guardians to authorize child participation in church youth events and provide medical information
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Privit Profile Instructions For Students
PDF template
Comprehensive guide for students to create and complete their digital health record using Privit Profile platform for Wilmington College.
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2022 23 SBHC Patient Intake Form
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Comprehensive medical intake form for patients at Generations Family Health Center, collecting personal, contact, and demographic information.
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New York FFA Association Waiver, Release Of Liability, Consent To Medical Attention, Authorizations
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Waiver form for New York FFA Association event participation, covering liability, medical consent, and risk acknowledgment.
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Claim Form
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A comprehensive claim form for medical reimbursement from GlobeMed Qatar/SEIB insurance network covering various healthcare services.
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WILDERNESS ADVENTURES ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREEMENT
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Legal document outlining risks, liability release, and participant agreement for wilderness adventure activities.
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POGS MAP Sickness Benefit Application Form
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A form for members of the Philippine Obstetrical and Gynecological Society to apply for sickness benefits for medical and COVID-related conditions.
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BHC Non Surgical Program Registration Form
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Registration form for patients seeking admission to a non-surgical program at Boone Hospital Center, collecting comprehensive personal and medical information.
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STANDARD MEDIA RELEASE FORM, ADULTS And MINOR CHILDREN
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A legal document granting Texas A&M AgriLife permission to use likenesses, names, and words of adults and minor children for various media purposes.
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Notice Of Privacy PracticeClinics
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A consent form documenting patient acknowledgment of privacy practices and permissions for health information disclosure and communication.
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Adult Medical Release Form
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Medical information and emergency authorization form for adult participants of the Summit Music Festival
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Long Term Disability Claim Form Statement Of Employee
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A comprehensive form for employees to file a long-term disability claim with Lincoln Financial Group, detailing personal, employment, and medical information.
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MEDICAL HISTORY FORM
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Comprehensive medical form for documenting student's health history, childhood illnesses, current physical conditions, and immunization records.
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PATIENTS INTAKE FORM
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Comprehensive medical intake form for patient registration and insurance information at a podiatry medical practice.
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IMPACT GRANT APPLICATION FORM
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A comprehensive form for submitting grant proposals at Ridge Meadows Hospital with detailed sections for applicant information, project summary, and departmental approvals.
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Easter Seals Colorado Rocky Mountain Village Camper Medical Form
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A comprehensive medical form for documenting a camper's health status and medical history prior to attending camp.
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Medical Release Form
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Medical consent and emergency contact form for minors attending music camp programs at Sam Houston State University
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Form For Documenting Medical And Physical Disabilities
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A form for healthcare professionals to document student medical disabilities and support academic accommodation requests.
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Online Privacy Policy Agreement
PDF template
Privacy policy detailing data collection, usage, and user rights for the Einstein Program website and online services.
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Garden Grove Teen Action Collaborative ApplicantS Information
PDF template
Consent and liability waiver form for participants in Garden Grove recreational programs and activities, specifically targeting teens.
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MLS Waiver Application Form
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Form for real estate professionals to request exemption from MLS agent fees based on specific qualifying conditions.
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2023 2024 Northside ISD Medical History
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Annual medical history form required for student participation in athletic activities at Northside Independent School District.
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2023 2024 UCSC Living Agreement Form
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A comprehensive roommate agreement form for creating a safe and mutually respectful living environment with guidelines for shared living spaces.
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Annual Pre Participation Physical Evaluation
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A comprehensive medical screening form for student-athletes to assess their health and fitness for sports participation during the 2023-24 school year.
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Name Based Criminal History Record Information ConsentInquiry Form
PDF template
A form authorizing a criminal history background check for various purposes including employment and working with specific populations.
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ASCVTS Bundang Thoracic Fellowship Program Application Form
PDF template
Application form for medical professionals seeking a fellowship in cardiovascular and thoracic surgery with the Asian Society for Cardiovascular and Thoracic Surgery.
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Informed Consent Form
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Consent form for police officer candidates participating in a physical fitness testing process that assesses physical readiness and potential health risks.
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2023 Teen Expeditions Questionnaire And Medical Form
PDF template
Comprehensive medical questionnaire for participants of Lake Champlain Maritime Museum teen expeditions to ensure safety and proper medical support.
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Preparticipation Physical Evaluation History Form
PDF template
Comprehensive medical history form for athletes to evaluate health status and potential medical concerns prior to sports participation
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PATIENT INTAKE FORM
PDF template
A comprehensive form for patients to complete and schedule appointments at various PanCare Health clinics in Florida counties.
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2023 JCC Maccabi Teen Medical Form
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Medical examination form for teens participating in JCC Maccabi sports and arts activities to verify physical fitness and health status.
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Student Medical Information
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A comprehensive medical form for collecting student health details, emergency contacts, and insurance information for educational program participation.
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2023 Rechelle Turner Basketball Camps Medical Release Form
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Medical release and consent form for participation in basketball camp, including emergency contact and insurance information.
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2023 FIU Summer Research Internship Program (SRI) Parental Consent Form
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Consent form for parents allowing their child to participate in Florida International University's Summer Research Internship program for students.
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Pre Employment Drug Testing Consent Form
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Consent form for pre-employment drug testing for job applicants at Burney Water District, outlining testing procedures and requirements.
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PW Hong Memorial Fellowship Program Application Form
PDF template
Application form for medical professionals seeking a fellowship with the Asian Society for Cardiovascular and Thoracic Surgery
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Media Release Form (For Non Patients)
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A legal document granting Southcoast Health System permission to use an individual's likeness and works for publicity and marketing purposes.
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Media Release Form (For Non Patients)
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A legal document granting Southcoast Health System permission to use an individual's image, likeness, and related works for promotional purposes.
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Travel Form
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A travel form for youth participants of North Cascades Institute's leadership program, requiring parental consent and emergency contact information.
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Pre Authorization Request Form
PDF template
A medical pre-authorization form for healthcare providers to request service approval from UHSM, detailing patient and provider information.
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Pre Authorization Request Form
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A form for healthcare providers to request pre-authorization for medical services from UHSM with detailed documentation requirements.
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Course Substitution And Waiver Form
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A form for students to request course substitutions or prerequisite waivers at Leech Lake Tribal College.
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Invoice Form For Morphology
PDF template
A detailed medical form for collecting patient morphological diagnostic information related to hematological conditions.
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2024 2025 Benefits Enrollment Form
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Form for employees to select health benefit plans, add or remove dependents, and update personal information for the upcoming benefits year.
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Garden Grove Teen Action Collaborative ApplicantS Information
PDF template
Waiver and consent form for participating in City of Garden Grove recreation programs, events, or activities for teens.
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Group Medical Plan Waiver Form
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A form for employees to waive medical plan coverage by certifying alternative health insurance coverage and understanding ACA requirements.
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Media Release Form
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A consent form allowing the Food Bank of Northeast Georgia to use interview content, photographs, and recordings for marketing purposes.
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TAPPS MEDICAL HISTORY FORM
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Annual medical history form for students participating in TAPPS athletic and fine art activities to assess health risks.
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Annual Pre Participation Physical Evaluation
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Medical evaluation form for student-athletes to assess physical fitness and health conditions for sports participation.
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Form 24 1b NCAA Division I Drug Testing Consent
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Mandatory consent form for NCAA Division I student-athletes agreeing to year-round drug testing and understanding associated regulations.
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Form 24 3f Drug Testing Consent NCAA Division III
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Consent form for student-athletes to agree to NCAA drug testing requirements for intercollegiate athletics participation.
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2024 2025 Sports Qualifying Physical Examination Medical Eligibility Form
PDF template
Medical form for determining student athletes' medical eligibility and participation in high school sports
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Sports Physical Examination Form
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Comprehensive medical evaluation form for students participating in school sports, requiring parental authorization and medical provider assessment.
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DATA PROTECTION POLICY
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A comprehensive policy outlining how CRESS UK protects personal data and complies with data protection legislation including DPA and GDPR.
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MEDICAL EXAMINATION FORM
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Medical form to assess physical and mental fitness of individuals applying for motorcycle event participation licenses.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for capturing individual health details, medical conditions, and consent for medical information sharing.
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MEDICAL EXAMINATION FORM
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A comprehensive medical examination form to assess physical and mental fitness for participating in motorcycle events.
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Preliminary Accident Report
PDF template
A comprehensive form documenting details of a vehicle accident, including driver, vehicle, and third-party information for insurance and risk management purposes.
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Background Check Authorization
PDF template
A confidential form authorizing a comprehensive background check for employment or volunteer purposes with personal information collection consent.
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FIDA Application Form
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Application form for submitting project proposals to the Fund for the International Development of Archives (FIDA), an initiative of the International Council on Archives (ICA).
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Patient Demographic Form
PDF template
A comprehensive form for collecting patient personal, contact, and insurance information for medical services.
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Informed Consent, Voluntary Waiver, Release Of Liability Assumption Of Risks Form
PDF template
Legal consent form for parents/guardians to authorize children's participation in summer youth programs at Clark State College, acknowledging risks and liability waivers.
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Ascension Illinois Influenza Vaccination Billing Form
PDF template
Medical form for collecting patient information for influenza vaccination and billing purposes.
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Social Media Release Form For Minors
PDF template
A legal release form allowing Corning Union High School to use a minor's likeness and information on social media platforms for promotional purposes.
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Child Medical Disclosure Form
PDF template
Medical information and emergency contact form for children attending summer camp, including health history and parental consent for medical treatment.
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Jersey Shore School Education Foundation Student Scholarship Form
PDF template
A scholarship opportunity for Jersey Shore Area High School graduating seniors pursuing healthcare-related college programs with awards of $1000 for one four-year and one two-year program recipient.
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2024 Health Insurance Waiver Form
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Form for employees to waive health insurance coverage and provide proof of alternative coverage under Affordable Care Act regulations.
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Kamehameha Schools Summer Programs Medical Forms
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Medical evaluation and health history form for children participating in Kamehameha Schools Summer Programs, requiring physical examination and immunization documentation.
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HPU Incoming Student Health Information And Immunization
PDF template
Comprehensive health form for incoming students at High Point University, including immunization records and medical consent.
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HSA Payroll Deduction Form 2024
PDF template
A form for employees to authorize payroll deductions for Health Savings Account contributions with IRS contribution limits and University contribution details.
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Pre Employment Health Clearance Requirements
PDF template
Comprehensive health screening requirements for new medical residents and fellows, including medical history, immunizations, and occupational health screenings.
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Incoming Trainee Timeline August 1, 2024
PDF template
Comprehensive timeline and requirements for incoming medical trainees, detailing necessary documentation and submission processes for licensing and staff appointment.
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2024 HIGH PERFORMANCE PLAYER WAIVER FORM
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Waiver and registration form for participants in athletic club activities, covering personal and emergency information along with liability release.
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2024 UNC Soccer Camp MEDICAL FORM
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Medical history and health screening form for participants of UNC Soccer Camp, required for camp participation.
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Medical History And Physical Examination Form
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Medical history and physical examination document for racing car drivers to assess fitness and health conditions for licensing.
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Eugene Metro Futbol Club Medical Release Release Of Liability Form
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Medical and liability consent form for youth soccer player registration and participation in soccer programs.
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Jr All American Of Southern California Conference Mandatory Medical Release Form
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Medical history and physical examination form required for youth athletes participating in Jr All American of Southern California Conference sports programs
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BOAT NUMBER ACCIDENT WAIVER AND RELEASE OF LIABILITY
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Legal waiver for participants in the Missouri American Water MR340 river race, acknowledging significant physical risks and releasing event organizers from liability.
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PLAN YEAR 2024 ENROLLMENTCHANGE FORM MEDICAL SPENDING CONVERSION (MSC) HEALTH BENEFITS BUY OUT WAIVE
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Enrollment form for New York City employees to participate in or terminate health benefits buy-out waiver program for plan year 2024.
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GENERAL MEDICALPHYSICAL EXAM FORM
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Medical examination form for veterans participating in the National Veterans Summer Sports Clinic, to be completed by a clinician.
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2024 FIU Cardiovascular Summer Research Internship Program (CV SRI) Parental Consent Form
PDF template
Consent form for parents allowing their child to participate in a summer research internship program at Florida International University.
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2024 Good Local Markets Vendor Media Release Form
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A legal document granting Good Local Markets permission to use an individual's photos and likeness for various publications and media purposes.
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20232024 Season
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Registration and medical information form for volleyball team participants, including contact details, medical history, and insurance information
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Pre Employment Drug Testing Consent Form
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Consent form for pre-employment drug testing for job applicants at Burney Water District, outlining testing procedures and consequences.
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St. Charles Park District Registration Form
PDF template
Registration form for participating in St. Charles Park District programs and activities, including waiver and participant information.
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2024 North Texas Soccer Tournament Of Champions Team Medical Release Confirmation Form
PDF template
A form confirming that medical release forms for players have been collected and will be available during tournament games.
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Credentials Check List For Tournament Teams
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Detailed guidelines for tournament team documentation and eligibility verification for Dixie Boys Baseball (DBB) tournaments.
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Subcontractor Risk Assessment Form
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A form to evaluate the risk level of subcontractors based on their performance and responsiveness
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Provincial Winter Fair Release Of Liability Acknowledgement Of Risk
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Legal document releasing liability for participants in provincial fair activities involving livestock and events
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2024 Youth SoccerFlag Football Camp Participant Enrollment Permission Form
PDF template
Enrollment and permission form for youth soccer and flag football camps organized by Pueblo of Laguna Sports & Wellness Diabetes Program.
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2025 Provider Referral Form
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A medical referral form for patients seeking enrollment in weight management or diabetes management programs through the Florida Department of Management Services.
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Media Release Form
PDF template
A legal document authorizing AATSP to use photographs, videos, and personal media of an individual or minor for promotional purposes.
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2025 ABC Travelling Fellowship Application Form
PDF template
Application for Canadian orthopaedic surgeons to participate in an international medical exchange fellowship program in the United Kingdom, Australia/New Zealand, or South Africa.
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External And Internal Student Media Release Form
PDF template
A form allowing parents or students to consent to media recording and publication of student images, work, and performances for promotional purposes.
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Disability Insurance Claim Packet Instructions
PDF template
Comprehensive guide for applying for disability insurance benefits through Standard Insurance Company, detailing claim submission process and requirements.
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Health Services Referral Form
PDF template
A comprehensive referral form for various health services targeting children, youth, and pregnant women in Mississippi.
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SoonerCareInsure Oklahoma Referral Form
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A referral form for healthcare providers to refer patients for medical services within the SoonerCare/Insure Oklahoma program.
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Alabama First Class Pre K Program Appendix F DECE Incident Report Form
PDF template
A standardized form for reporting serious accidents, injuries, medical situations, or behavior incidents in the Alabama First Class Pre-K Program.
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2020 Eve Gene Black Summer Medical Career Program FAQs
PDF template
Comprehensive guide for a medical mentor/internship program for students in Los Angeles and adjacent counties
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Everence HSA Contribution Form
PDF template
A form for making individual contributions to a Health Savings Account through Everence Federal Credit Union with tax year specification options.
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Data Protection Consent Form
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Consent form for processing personal data related to the CSABOT project, outlining data collection, usage, and privacy rights.
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Summary Of The Rule (Title 42 CFR Part 2 Confidentiality Of Alcohol And Drug Abuse Patient Records
PDF template
Detailed guidelines for creating valid consent forms for disclosing patient information in alcohol and drug abuse treatment programs.
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Apricus Referral Form
PDF template
A comprehensive medical referral form for patient discharge planning and facility care management services.
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Physician Examination Form
PDF template
A comprehensive medical form required for students to provide health information and undergo physical examination prior to campus arrival.
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Participant Liability Release And Waiver Form
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A comprehensive liability release form for participants in cheer and dance events organized by Varsity Spirit LLC.
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USA Volleyball Incident Report Form
PDF template
Comprehensive form for documenting injuries or property damage during USA Volleyball events
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Monthly Grant Funding (MGF) Payment Inquiry Form
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Form for community partner clinics to inquire about missing grant funding payments for enrolled participants.
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Health Home Participation Authorization And Information Sharing Consent
PDF template
A consent form allowing patients to authorize health information sharing and participation in a Health Home program with specific privacy protections.
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Media Release Form
PDF template
A legal document authorizing use of personal stories, images, photos, and videos for advocacy purposes across various media platforms.
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PATIENT FEEDBACK FORM
PDF template
A form designed for patients to provide feedback or file complaints with Big Island Healthcare, allowing anonymous submission and formal review process.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting new patient health information, medical history, and family health background.
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Enrollment Form
PDF template
A comprehensive form for collecting student and family details, including contact information, family history, and hearing loss information.
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Student Medical Form
PDF template
Comprehensive medical form for collecting student health information, medical history, and emergency contact details.
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Wisconsin Youth Soccer Association Event Medical Release Form
PDF template
Medical and liability release form for youth soccer participants, covering medical consent and injury acknowledgment.
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Notice Of Serious Incident
PDF template
Official documentation of a medical incident involving a resident at a behavioral health facility who experienced seizures and required medical transport.
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COMMONWEALTH OF MASSACHUSETTS CATEGORICAL TUITION WAIVER APPLICATION 2024 2025
PDF template
Application for tuition waiver categories at Cape Cod Community College for eligible students including veterans, seniors, and other special categories.
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Emergency Contact Form
PDF template
A comprehensive emergency contact and medical information form for high school band and dance students in Fort Bend Independent School District.
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24 25 Physical Examination Form
PDF template
Medical form for student athletes to document physical fitness and health status for school sports participation.
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2024 Nomination Form
PDF template
A comprehensive nomination form for an award, requiring detailed nominee information and supporting documentation.
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Accommodation Request EmployeeS Serious Health Condition Medical Form
PDF template
A form for employees to request workplace accommodations due to serious health conditions, requiring medical provider verification and details.
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DSHS Client Identification And Consent Form
PDF template
A form allowing the Department of Social and Health Services to share confidential client information with authorized agencies and providers for service coordination.
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Club Sport Waiver 2024 2025
PDF template
Legal waiver for Villanova University students participating in club sports during the 2024-2025 academic year, acknowledging potential risks and releasing the university from liability.
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UC ANR Waiver
PDF template
A legal waiver for participants attending the 2018 Western Region Leaders Forum events, releasing the University of California from liability for activities and potential risks.
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DSS Form 2901 Medical Statement
PDF template
Medical health form for staff, volunteers, and emergency personnel working in child care services, documenting health history and tuberculosis status.
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Medical Statement
PDF template
A medical health screening form for staff, volunteers, and emergency personnel working in child care settings in South Carolina.
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Medical Statement
PDF template
Medical health screening form for staff, volunteers, and emergency personnel in child care services in South Carolina.
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Suicide Risk Assessment Forms Form Over Substance
PDF template
An academic article examining the challenges and limitations of suicide risk assessment forms in psychiatric patient evaluation and management.
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Non UH Event Or Activity Participant Consent, Waiver, Release And Indemnity Agreement
PDF template
Legal document outlining participant consent, risk acknowledgment, and liability release for non-University of Hawaii events or activities.
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Participant Consent, Waiver, Release And Indemnity Agreement Non UH Event Or Activity
PDF template
A legal consent and release form for participants in non-University of Hawaii events, outlining health representations, risk assumptions, and liability waivers.
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Booking Form
PDF template
A comprehensive form for pet owners to provide details when boarding their cat at a veterinary facility.
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COVID 19 VACCINATION CONSENT FORM
PDF template
Consent form for receiving COVID-19 vaccines at Public Health Seattle & King County Vaccination Sites.
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CLAIM FORM FOR HEALTH DEPENDENT CARE EXPENSES
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A form for employees to request reimbursement for health and dependent care expenses through their Flexible Spending Account (FSA)
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Consent To Publish PicturesTestimonialsRecordingsVideo
PDF template
A legal document granting Algoma University permission to use an individual's pictures, testimonials, recordings, or videos for advertising and informational purposes.
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University Of Kentucky Medical Inquiry Form In Response To An Accommodation Request
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Medical form used to assess an employee's disability status and potential accommodations under the Americans with Disabilities Act (ADA)
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PATIENT MEDICAL HISTORY FORM
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Comprehensive medical form capturing patient personal information, current medications, allergies, and past medical history details.
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New Patient Intake Form
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Comprehensive medical intake form for new patients seeking holistic healthcare at the Riordan Clinic, collecting detailed personal and medical information.
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Hazard Report Form
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A form for reporting potential safety hazards and risks in an aviation environment.
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Laboratory Supply Order Form
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Form for ordering laboratory specimen collection and shipping supplies for various medical testing needs.
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Form CS3 Student Consent
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A consent form for primary students (Grades JK-3) outlining responsible technology use and parental agreement guidelines.
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Form CS4 Student Consent
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Consent form for students in grades 4-8 outlining responsible technology and internet usage guidelines.
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Camp Blue Spruce Medical Form 2016
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A comprehensive medical form for campers to provide health and emergency contact information for Camp Blue Spruce summer camp.
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PIP Checklist
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A comprehensive checklist for healthcare providers to ensure complete documentation and submission of required forms for personal injury protection insurance claims.
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Rotation Assessment Form
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A medical assessment form for evaluating thoracic spine mobility and potential biomechanical issues.
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PERSONNEL SCREENING, CONSENT AND AUTHORIZATION FORM
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A form for conducting personnel screening and obtaining consent for background checks or employment verification.
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AAOS CME SKILLS COURSE REGISTRATION FORM
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Registration form for AAOS Fundamentals of Knee & Shoulder Arthroscopy course for orthopaedic residents in September 2024.
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Institutional Drug Testing Program Student Athlete Notification Form
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A form documenting notification and consent for drug testing of student-athletes at an educational institution.
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Ohio Administrative Code Rule 3344 94 03 Policy
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Administrative policy outlining safety and communication protocols for university programs involving minors, including emergency procedures and medical considerations.
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Student Parent Guardian Extracurricular Activities Drug Testing Consent Form
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A consent form allowing Kimberly School District to conduct random drug testing for students participating in extracurricular activities.
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Standardized Application For Pathology Fellowships
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Comprehensive application form for physicians seeking pathology fellowship training at the University of Texas Southwestern Medical Center.
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Make A ChildS Smile Parental Consent Form
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A consent form for preventive dental services for school-aged children provided by the Mississippi State Department of Health.
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Incident Report Form
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A comprehensive form for documenting workplace or program-related incidents, including details about the incident, individuals involved, and follow-up actions.
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Risk Assessment Form
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A form for students to document potential risks and safety precautions for science fair research projects involving animals and equipment.
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Background Check Consent Form
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A consent form allowing an organization to conduct background investigations and consumer reports on an individual for employment or volunteer purposes.
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MEDICAL HISTORY FORM
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Comprehensive medical form collecting patient personal health information, medical history, family history, and COVID-19 screening details.
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REENTRY (REPS) SERVICE REQUEST FORM
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A form used by healthcare providers to request medical services for patients in the California Department of Corrections and Rehabilitation system.
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PAXLOVID ORDER FORM FOR OUTPATIENT ORDER SET PER FDA EUA
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Medical order form for prescribing Paxlovid, an emergency use authorization (EUA) medication for treating mild-to-moderate COVID-19 in eligible patients.
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Volunteer Coaching Release Of Liability
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Legal document releasing the university from liability for risks associated with volunteer coaching activities.
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Form 401 AGeneral Information Acceptance Of Appointment And Consent To Serve As Registered Agent
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Official form for documenting acceptance and consent of a registered agent for a business entity in Texas.
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Waiver Of Service Period For Retirement Plan Participation
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A form allowing employees to waive the one-year service requirement for retirement plan participation based on previous employment at eligible organizations.
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HIPAA 404P Authorization To Release Or Obtain Health Information
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A form for authorizing the release or obtaining of protected health information under HIPAA guidelines.
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Receipt And Waiver Of MechanicS Lien Rights
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A legal document used to waive mechanic's lien rights upon receipt of payment for labor, materials, or services provided to a property.
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Media Release Policy
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Policy governing the authorization and use of media featuring students, faculty, and staff in public communications.
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Cat Adoption Interest Application
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A comprehensive form for individuals interested in adopting a cat, requiring detailed personal and household information.
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Consent Form For Parents Of Deceased Children
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Consent form for parents to provide permission for a child's stored biological sample to be used in a research study about neuroblastoma epidemiology.
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Parental Permission For A Minor Child To Participate In A Research Study
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Consent form for parents to allow minor children to participate in a research study about neuroblastoma epidemiology.
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Consulting PhysicianS Compliance Form
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Medical form for documenting terminal illness assessment, patient competency, and informed decision-making for end-of-life care.
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DOH 422 066 PsychiatricPsychological ConsultantS Compliance Form
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A medical form for documenting psychiatric evaluation and patient mental health status compliance assessment.
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Hazard Incident Report Form
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A form for documenting and reporting workplace safety hazards, incidents, and recommended corrective actions.
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Electronic Funds Transfer (EFT) Waiver Request Form
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Form for requesting exemption from electronic funds transfer payments by providing specific justification to the Federal Aviation Administration.
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Medical Service Request Form
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A form for healthcare providers to request medical services for South Country Health Alliance members with detailed service and patient information.
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HealthFlex Mandatory Premium And Coverage Waiver Form
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A form for enrolled participants or new hires to decline HealthFlex health plan coverage and declare their reason for doing so.
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Youth Member Health History Information
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A comprehensive health information form for youth members participating in 4-H programs, collecting medical history, medications, and special needs information.
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OSA Risk Assessment Form
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A comprehensive form for students to assess potential safety risks in scientific research projects and experiments.
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SI 2047 Your Disability Benefit Claim
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Comprehensive guide and forms for applying for disability insurance benefits, including instructions for claim submission and potential benefit reductions.
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Out Of Network Reimbursement Form
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A form for employees to submit out-of-network healthcare service reimbursement claims with detailed patient and service information.
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Background Check Consent Form
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Consent form authorizing criminal and driver's history record checks for employment with Cobb County School District.
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Four Corners Dressage And Combined Training Association Membership Application Form
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Membership application form for Four Corners Dressage and Combined Training Association with various membership levels and waivers.
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COVID 19 Participant Code Of Conduct And Risk Assessment Form
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A risk assessment and conduct guidelines form for Special Olympics participants during the COVID-19 pandemic
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Authorization To Disclose Confidential Information
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A form authorizing the release of personal medical information to specified parties with details on the type and purpose of disclosure.
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4 H Media Release Form
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A legal document granting Virginia Tech permission to use an individual's image, voice, and performance for educational and promotional purposes.
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Georgia 4 H Participation Agreement And Waiver Form
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A legal waiver for participants in Georgia 4-H virtual programs, covering liability and consent for program participation.
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Health Requirements For Matriculation
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Comprehensive health documentation requirements for students, detailing mandatory vaccinations and immunization guidelines.
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Youth Activities Media Release Form
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A media consent form allowing the University of Wisconsin-Whitewater to use a participant's image and likeness for various purposes.
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Suburban Law Enforcement Academy Medical Examination Package
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Medical examination and approval form for police recruit candidates to assess fitness for law enforcement training program
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Patient Intake Form
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Comprehensive form for collecting patient personal, medical, insurance, and contact information for healthcare providers.
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M TIBA OUTPATIENT CLAIM AND PRE AUTHORIZATION FORM
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A comprehensive healthcare claim form for submitting outpatient medical treatment details and seeking pre-authorization for medical services.
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Human Informed Consent Form
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A template form for obtaining informed consent from research participants in science fair projects, covering voluntary participation and study details.
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Middlesex School TB Risk Assessment Form
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A medical form to assess tuberculosis risk for students by evaluating travel history, exposure, and potential testing requirements.
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Research Involving Decisionally Impaired Participants
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Establishes guidelines and protections for conducting research involving participants who cannot provide voluntary informed consent due to decisional impairment.
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Weekly Disability Claim Form
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A comprehensive form for reporting disability status and medical information for the Greater St. Louis Construction Laborers' Welfare Fund.
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ILR Emergency Medical Form
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A comprehensive form for participants to acknowledge risks, provide emergency medical information, and grant permissions for Institute for Learning in Retirement activities.
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Disability Claim Application Forms
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Comprehensive documentation requirements for submitting a disability insurance claim with multiple form and document submission instructions.
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Required NYS School Health Examination Form
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Comprehensive health examination form for New York State school students, capturing medical history and current health status.
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Form To Be Filled By Appointee On Stipendiary Assignments Of DJST
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Application form for candidates seeking stipendiary assignments at Seth G.S. Medical College & K.E.M. Hospital Diamond Jubilee Society Trust
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Chronic Illness Benefit Application Form 2013
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Medical application form for registering chronic illness benefits with Discovery Health Medical Scheme for the year 2013
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Volunteer Criminal Background Check Consent Form
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A consent form for volunteers to authorize a criminal background check by Orange County Community Resources.
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UMKC School Of Dentistry Patient Referrals
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A comprehensive form for referring patients to various dental specialty clinics at the UMKC School of Dentistry.
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Aflac Continuing Disability Claim Form
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A form for submitting continuing disability claims with Aflac insurance, providing instructions for online form completion and submission.
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Seasonal Survey On Influenza Vaccination Programs For Healthcare Personnel
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A survey collecting information about influenza vaccination programs and practices for healthcare personnel across different employment groups.
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Medical Form
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A medical form for applicants to Notre Dame Seminary's Graduate School of Theology Priestly Formation Program, collecting health and insurance information.
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Personal Medical History
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Comprehensive medical history form for collecting patient health information, medical conditions, family history, and current health status.
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Athlete Nomination Form
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Comprehensive form for athlete registration, personal details, sports experience, and consent for international sporting events
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WAIVER FORM
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A legal form allowing clients to waive a real estate licensee's statutory duty to present all offers in a real estate transaction.
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FMLA Leave Request Form
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A form for employees to request leave under the Family and Medical Leave Act for various personal and family medical reasons.
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Waiver Of Compulsory Attendance Form
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A legal form allowing parents to request exemption from compulsory school attendance for a student aged 16-17 in Kansas.
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Data Processing Agreement
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Legal agreement outlining data processing terms between Jasper AI and its customers for handling personal data.
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Chair Assessment And Delivery Environmental Questionnaire
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A comprehensive form for evaluating chair specifications, sizing, and delivery requirements for personalized seating solutions.
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Gibraltar Residency Application
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A comprehensive overview of letters of intent for residency applications, explaining their purpose, benefits, and strategic writing approach.
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Informed Consent, Release Agreement, And Authorization
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A legal document for participants or guardians providing consent and medical authorization for Scouting activities and emergency medical treatment.
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Informed Consent, Release Agreement, And Authorization
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A legal document providing consent, medical authorization, and risk acknowledgment for participation in Scouting activities.
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Meditech Patient Portal Adult Proxy Consent Form
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Form allowing an adult to grant proxy access to their medical portal record for another designated adult representative.
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Parish Hazard Report Form
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A form used to document and report potential safety hazards within a parish or church site, including hazard details and corrective actions.
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Student Health Information Form
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Comprehensive health information form for collecting student medical and contact details at a university
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Lamar Consolidated ISD Athletic Forms Packet
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Comprehensive packet of required forms for student-athletes participating in Lamar CISD athletic programs, including medical and consent documentation.
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Valley ChildrenS Healthcare Outpatient Referral Form
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A comprehensive medical referral form for patients being referred to Valley Children's Healthcare for specialized medical services.
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Electronic Recording Interview Form
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A form documenting consent for electronic recording of police interviews in Truro, Massachusetts.
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Medical Referral Form
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A form for reporting an individual's medical conditions that may impact their ability to safely operate a motor vehicle.
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MSDH Motivated To Live A Better Life Referral Form
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A comprehensive referral form for patients seeking health management support through the Mississippi State Department of Health's lifestyle program.
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Record Of Risk Assessment Southampton Hydro Team On Site Construction
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Risk assessment document for construction work by Southampton Hydro Team, detailing potential hazards and control measures during project preparation.
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Hazard Report Form
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A form for documenting workplace safety hazards, their severity, and corrective actions.
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Online Privacy Policy Agreement
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Privacy policy outlining data collection, usage, and user rights for King Mastery, International, LLC's website and online services.
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Athletic Injury Report (AIR) Form Information And Procedures
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Comprehensive guidelines for documenting and reporting athletic injuries in high school and middle school athletic programs.
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Medical History Form
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Comprehensive medical form for students to provide health history and undergo medical screening for enrollment.
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SSU Admission And Discharge Form
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Medical intake and release document for detainees in immigration health services facilities, tracking health status and disposition.
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Questions And Answers From Early Intervention Insurance Assessment Webinar
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A comprehensive document addressing questions about insurance processes in early intervention services and related forms.
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Pyxis Access Request Form
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Form for healthcare professionals to request access to Pyxis medication management system in specific work areas.
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2019 Jijak Youth Camp Medical Release Form
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A comprehensive medical form for youth camp participants to provide health information, allergies, immunization status, and medical details.
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Medical History Form
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A comprehensive medical history form for sports participation, requiring detailed health information and consent statements.
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WakeMed Urgent Care Patient Intake Form
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Medical form for collecting patient health information, medical history, and current health status at urgent care facility.
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90 Day Waiver Request Form
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Form for providers to request a 90-day waiver for claims submission to MassHealth outside standard time limits.
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Name Based Criminal History Record Information ConsentInquiry Form
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A consent form for conducting criminal history record checks for various employment and personal purposes in Georgia.
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EPA Property Access And Air Sampling Consent Form
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A consent form allowing US Environmental Protection Agency to conduct air monitoring and sampling on a specific property under CERCLA regulations.
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COVID 19 Participant Code Of Conduct And Risk Assessment Form
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A comprehensive guidance document outlining participant responsibilities and precautions for COVID-19 safety during Special Olympics activities.
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Sterilization Consent Form Detailed Instructions Guide
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Detailed guide for healthcare providers on submitting sterilization consent forms to Medicaid's fiscal agent, Gainwell.
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Eyer Ropes Challenge Course Release Of Liability, Waiver Of Claims, Assumption Of Risk And Indemnity
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Legal document releasing liability for participation in high-risk recreational activities at Eyer Ropes Challenge Course.
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Refund Process Policy
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A policy outlining procedures for processing refunds, credit balances, and overpayments for UCR Health patients and third-party payors.
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WakeMed Urgent Care Patient Intake Form
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Comprehensive medical form for collecting patient medical history, past surgical history, family history, and social history at an urgent care facility.
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DOT Physical Examination Form
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Medical examination form for commercial vehicle drivers to assess physical fitness for driving.
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Advancing Access Patient Information Form
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Comprehensive form for collecting patient personal information, contact preferences, and insurance details for medical services.
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Authorization For The Release Of InformationPrivacy Act Notice To The U.S. Department Of Housing And
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A form authorizing HUD and housing agencies to request and verify personal financial information for housing assistance purposes.
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HUD 9887A Fact Sheet
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Document package for housing assistance applicants providing consent for verification of personal information by HUD and related agencies.
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Subscriber Claim Form
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A comprehensive insurance claim form for submitting medical service reimbursements to Blue Cross Blue Shield of Massachusetts.
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Waiver Of Liability Hold Harmless Agreement
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Legal document releasing Sam Houston State University from liability for risks associated with study abroad program participation.
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Medical History Form
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A comprehensive form for collecting patient medical history, current health conditions, medications, and allergies.
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Request For Waiver Form
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A form for contractors to request a waiver of Minority-Owned Business Enterprise (MBE) or Women-Owned Business Enterprise (WBE) participation goals in a procurement process.
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S355 Community Facility Hazard Report Form
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A form for reporting potential hazards in community facilities that may cause injury, with sections for hazard details and council investigation.
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GASLINI INTERNATIONAL PEDIATRIC FELLOWSHIP PROGRAM APPLICATION FORM
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Application form for medical professionals seeking a fellowship at IRCCS Istituto Giannina Gaslini's pediatric program.
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SPECIAL MEETING HOD COMMITTEE VOLUNTEER FORM
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A form for volunteers to indicate interest in serving on various committees for a Special Meeting of the House of Delegates.
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Prospective Tenant Background Check Consent Form
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A consent form for prospective tenants to authorize a criminal background check for rental application purposes.
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Preparticipation Physical Evaluation Physical Examination Form
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Medical evaluation form used to assess an athlete's physical fitness and eligibility to participate in sports activities.
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Preparticipation Physical Evaluation Physical Examination Form
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A comprehensive medical evaluation form for athletes to assess physical fitness and clearance for sports participation.
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Amino Acid Laboratory Sample Submission Form
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A comprehensive form for submitting animal medical samples to the Amino Acid Laboratory at UC Davis for testing.
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Submission Form
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A form for authors submitting manuscripts to Acta Anaesthesiologica Scandinavica, including conflict of interest disclosure requirements.
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Uniform Donor Risk Assessment Interview Forms
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Guidance document for professionals conducting donor risk assessment interviews for organ, tissue, and eye donation.
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UNPLANNED ADMISSIONAAU BOOKING FORM
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A form for booking unplanned hospital admission to the Acute Admissions Unit with comprehensive patient and clinical details.
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AAUS Medical Evaluation Of Fitness For Scuba Diving Report
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A comprehensive medical evaluation form to assess an individual's fitness for scientific scuba diving, including required medical tests and physician's assessment.
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Alberta Accident Benefits Initial Claims Process
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A comprehensive guide for filing insurance claims and accessing medical benefits after an automobile accident in Alberta, Canada.
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AIChE BEER BREWING COMPETITION WAIVER AND RELEASE OF LIABILITY FORM
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Legal waiver for participants in an AIChE beer brewing competition, releasing the organization from potential liability and risks associated with the event.
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Directions For Completing An ABPN Feedback Module
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Instructions for psychiatry and neurology professionals to complete a peer or patient feedback module for continuous certification.
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AAPS VOLUNTEER FORM
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A volunteer form for physicians to indicate interest in committee participation and specialty opportunities within the AAPS organization.
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Industry Abstract Submission Form
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A form for submitting clinical research abstracts to be considered for presentation at The Aesthetic Meeting 2021.
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Hardship Waiver Form
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Form for Louisiana school districts to request a waiver of financial aid application requirements for graduating high school seniors unable to complete standard financial aid documentation.
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Consumer Authorization Form
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A form authorizing a licensed sales agent to assist with health insurance marketplace application and enrollment processes.
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Marketplace Consent Form
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A consent form allowing a health insurance agent to access and assist with Marketplace health insurance enrollment and application processes.
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Histology Submission Form
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A detailed form for submitting tissue samples to the UConn Comparative Veterinary Medicine Diagnostic Laboratory for histological processing and analysis.
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Patient Intake Form
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Comprehensive form for collecting patient personal, medical, insurance, and contact information for healthcare services.
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Group Insurance Accelerated Benefit Option Claim Form
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A form for employees or members to claim an accelerated benefit option for terminal illness life insurance claims.
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Research Proposal Form (For Projects Using CentRIC Datasets)
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A proposal form for researchers seeking to use datasets from the Centre for Psychosocial Research in Cancer (CentRIC+)
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Accessible Parking Form
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Application form for individuals with disabilities seeking an accessible parking permit at Eastern Kentucky University
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Group Accident Insurance Claim Form
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A comprehensive claim form for reporting and documenting accident-related insurance claims with detailed instructions and submission guidelines.
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Accidental Injury Claim Form
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Insurance claim form for documenting details of an accidental injury and related medical information for potential insurance coverage.
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Credit Disability Claim Form
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Instructions for submitting a disability insurance claim for loan protection coverage through American National Insurance Company.
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Northeastern University AccidentIncidentNear Miss Report Form
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A comprehensive form for reporting accidents, incidents, or near misses involving students, employees, or visitors at Northeastern University.
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Club Sports Accident Report Form
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A comprehensive form for documenting sports-related accidents and injuries for recreational sports participants
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IADT Accident Report Form
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Comprehensive form for documenting workplace accidents, injuries, and subsequent medical treatment with GDPR compliance notice.
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AccidentIncident Reporting Form
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Comprehensive guidelines for reporting accidents, incidents, and hazards on university premises, detailing reporting processes and medical response protocols.
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Accident Waiver And Release Of Liability Form
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A legal document that releases event organizers from liability and outlines participant responsibilities for various activities.
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ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
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A legal document that releases event organizers from liability and assumes personal risk for participation in an activity.
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Accident Waiver And Release Of Liability Form
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Legal document releasing event organizers from liability for potential injuries or damages during the White River Dragon Boat Race and Festival.
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Accident Waiver And Release Of Liability Form
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Legal document waiving liability for participants in indoor baseball training activities, releasing the organization from potential injury or damage claims.
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Accident Waiver And Release Of Liability Form
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A legal document releasing the Lupus Foundation of America and event venue from liability for participation in an outdoor movie event.
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BOROUGH OF OAKLAND ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
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A legal document that releases the Borough of Oakland from liability for potential injuries or damages during an event or activity.
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Accident Waiver And Release Of Liability Form
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Legal document releasing Lincoln Academy from liability for potential risks and injuries during summer camp participation.
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Accident Waiver And Release Of Liability Form
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Legal document releasing event organizers from liability for potential injuries or damages during participant's event involvement.
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Accident Waiver And Release Of Liability Form
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Legal document outlining risk acknowledgment and liability release for participation in Swerve Robotics activities and workshops.
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Release And Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
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A legal document releasing Shiloh Christian School from liability for potential injuries or damages during school activities.
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Accident Waiver And Release Of Liability Form
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A comprehensive legal form releasing liability for various activities and events, covering potential risks and participant responsibilities.
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ACCIDENT WAIVER PDCS 5127a
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Waiver form for candidates participating in a physical fitness screening test for a civil service position in Suffolk County, NY.
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Accident Waiver And Release Of Liability Form
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A comprehensive liability waiver for parents allowing children to participate in summer art sessions with acknowledgment of potential risks and medical authorization.
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Accident Wellness Benefit Claim Form
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Insurance claim form for submitting wellness screening benefits and personal health information to Guardian Life Insurance.
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Accommodation Request Assessment Form
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A medical form used to assess an employee's request for workplace accommodation due to disability or pregnancy-related needs.
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Accommodation Inquiry Form
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A form to collect details about research study requirements and preferences for MRI scanning services.
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Accommodations Waiver Form
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A form for students at Texas Tech University Health Sciences Center El Paso to voluntarily waive existing disability accommodations.
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Account Creation Consent Form
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A consent form for parents/guardians to create an online account for students under 13 with College Board services.
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MEDICAL RELEASE FORM
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A form granting permission for medical treatment of a student during official academy participation with emergency contact and medical information.
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Waiver Form
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A consent form allowing the US Department of Health and Human Services to use an individual's image, video, and personal story for promotional purposes.
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Waiver Form
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A form granting the US Department of Health and Human Services permission to use an individual's photograph, likeness, artwork, profile, or story in various media formats.
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Student Inquiry Form
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A form for students seeking internships, clinical rotations, and other experiential learning opportunities with the Allegheny County Health Department.
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ACH Pre Authorization Form
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A form authorizing automatic payment deductions for medical consultations and services from a bank account.
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CLAIM FORM
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A comprehensive insurance claim form for collecting detailed policyholder and incident information for processing an insurance claim.
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Acknowledgement Of Risk And Waiver Of Liability
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A comprehensive guide for campus departments on using risk and liability waivers for various activities involving physical activity, travel, or minors.
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Activity Participation Waiver
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A legal document that outlines participant risks and releases the organization from liability during an activity
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Acknowledgment Of Risk And Consent Form
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Legal document for voluntarily participating in a college activity with acknowledgment of potential risks and liability waiver.
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Allegany College Of Maryland Media Release Form
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A consent form allowing the college to use student images, videos, and information for educational and promotional purposes.
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Insurance Application Form
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Comprehensive insurance application form for property coverage with multiple sections for property details, coverage options, and risk assessment.
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Patient Medical History Form
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Comprehensive medical history form for collecting patient health information, symptoms, and medical conditions.
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Medical Information
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A comprehensive medical form collecting personal health details for emergency preparedness at an event or track setting.
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WAIVER OF AGENCY DUTIES BUYER FORM
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Legal document detailing fiduciary duties of real estate licensees and potential waivers of certain agency responsibilities.
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PARENTSTUDENT PHYSICAL ACTIVITY WAIVER FORM
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A comprehensive waiver form for students participating in physical activities at Christendom College, outlining potential risks and legal protections.
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Activity Booking Form
PDF template
Comprehensive booking form for outdoor activity and course registration with liability acknowledgment and consent details.
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Activity Participation Waiver Form
PDF template
Legal document that releases Brightpoint Community College from liability for student participation in college activities
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ACTIVITYPROGRAM RELEASE And WAIVER FORM
PDF template
A legal document for releasing liability and obtaining consent for participation in organizational activities or programs.
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Activity Waiver Form (Release, Waiver And Covenant Not To Sue)
PDF template
A legal document that releases Cape Fear Community College from liability for risks associated with participating in an activity or event.
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Naugatuck Valley Activity Waiver Form
PDF template
A comprehensive waiver form for students participating in college-sponsored activities, covering transportation, emergency contacts, and liability release.
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Patient Intake Form Holistic Health Assessment
PDF template
Confidential questionnaire for determining patient treatment plan and collecting comprehensive medical and personal information.
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Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, contact, medical, and insurance information for chiropractic services.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Joyanne Kohler Acupuncture, collecting personal and health information.
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Acute Inpatient Hospital Assessment Form
PDF template
Form for requesting authorization for hospital admissions and stay extensions for Blue Cross and Blue Care Network commercial plans
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Americans With Disabilities Act Accommodation Request Assessment Form
PDF template
A form for employees to request workplace accommodations under the Americans with Disabilities Act, requiring medical provider documentation of work restrictions or limitations.
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Medical Inquiry Form In Response To An Accommodation Request
PDF template
A medical form used to evaluate an employee's disability and potential workplace accommodations under the Americans with Disabilities Act (ADA).
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Letter Of Recommendation WaiverRequest Form
PDF template
A form for students to request and recommenders to submit confidential letters of recommendation at Harvard University's Adams House.
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DOH 3608 Uninsured Care Programs Medical Eligibility Form
PDF template
A medical form used to determine patient eligibility for HIV-related care programs in New York State
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ADA Job Accommodation Request And Medical Inquiry Form
PDF template
A confidential form to help determine reasonable workplace accommodations for employees with disabilities under ADA guidelines.
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Diagnostic Imaging Referral Form
PDF template
Comprehensive medical imaging request form for various ultrasound, x-ray, and pain therapy procedures with detailed anatomical options.
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Pre Authorization Form Instructions
PDF template
Detailed instructions for completing a medical pre-authorization request form, including required documentation and submission process.
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Medical Form Instructions For TeamSnap
PDF template
Step-by-step guide for team managers to upload player medical forms to TeamSnap profiles
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Required NYS School Health Examination Form
PDF template
A comprehensive health examination form for students in New York State, documenting medical history and current health status
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Additional Shifts Approval Form
PDF template
Form for documenting and approving additional paid shifts for medical residents and fellows beyond their normal program requirements.
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Private Hospitals Discharge Form (ADF96)
PDF template
A comprehensive form for collecting detailed patient discharge data from private hospitals for statistical reporting purposes.
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Vermont Advance Directive For Health Care
PDF template
A legal document allowing individuals to specify their health care preferences and designate a health care decision-maker if they become unable to make decisions for themselves.
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AdjustmentVoid Request Form
PDF template
A form used by healthcare providers to request adjustments or void payments for medical services.
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ADMFRM2 Laboratory Submission Form
PDF template
A comprehensive form for submitting animal health specimens to the Animal Health Laboratories for veterinary diagnostic testing.
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Administrative Waiver How To Request Waiver For An Overpayment Under 1000
PDF template
Instructions for requesting an administrative waiver for Social Security overpayments less than $1,000.
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Admission Agreement And Health Assessment
PDF template
Comprehensive form for child enrollment, medical history, emergency contacts, and health assessment for childcare or educational settings.
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ADMISSIONS SUBSTITUTION AND WAIVER FORM
PDF template
Form for requesting course substitutions and waivers for pre-requisite requirements during the admissions process at UTHSC.
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Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
Official form for high school students to participate in athletic activities, including eligibility verification and parental consent.
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Adobe Generative AI Additional Terms
PDF template
Supplemental legal terms governing the use of Adobe's generative AI features, including guidelines for content input and output.
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Adolescent Vaccination Consent Form (TdapTd, HPV, Meningococcal ACWY)
PDF template
A consent form for parents/guardians to authorize vaccination of adolescents for Tdap/Td, HPV, and Meningococcal ACWY vaccines.
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Adoption Agreement
PDF template
A comprehensive adoption agreement for pet adoption, outlining medical information, fees, and adoption terms.
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Hospice Volunteer Application Form
PDF template
A comprehensive application form for individuals interested in becoming hospice volunteers, collecting personal, contact, and background information.
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MINOR PARTICIPANT EMERGENCY CONTACT AND MEDICAL RELEASE FORM
PDF template
A comprehensive form for collecting emergency contact, medical information, and release authorization for a minor participant.
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FMLA Adult Child Disability Medical Inquiry Form
PDF template
A medical form used by the New Mexico Taxation & Revenue Department to determine disability status for FMLA leave to care for an adult child.
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Informed Consent Document Template
PDF template
A template for creating an informed consent document for research study participants explaining study details, procedures, risks, and benefits.
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Girl Scouts Of Greater Los Angeles Adult Emergency Information And Authorization For Treatment
PDF template
Emergency contact and medical authorization form for Girl Scouts of Greater Los Angeles adult participants
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Adult Registration Form
PDF template
A comprehensive form for collecting patient personal and demographic information for healthcare services.
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Adult HIV Confidential Case Report Form
PDF template
Confidential medical reporting form for adult HIV patients in Rhode Island, used for surveillance and epidemiological tracking.
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New Patient Intake Form
PDF template
Comprehensive intake form for new patients to collect personal and medical contact details at a healthcare practice.
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Adult Legal Form
PDF template
A legal form for adult participants in CISV international programs covering medical guardianship, release, and program consent.
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Emergency Medical Form ADULT
PDF template
Comprehensive medical authorization and emergency contact form for adult participants in MUMC trips.
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Oklahoma 4 H Youth Development Participant Information Form
PDF template
A comprehensive form for collecting participant health, emergency contact, and medical information for 4-H youth programs and events.
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Adult Confidential Medical Information And Emergency Notification Form
PDF template
Comprehensive medical information and emergency contact form for participants in the 2007 Big Sky Regional Science Bowl
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Adult Medical Release Form
PDF template
Medical and liability release form for participants in Diocese of Little Rock youth ministry events
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Adult Medical Release Form
PDF template
Medical release and consent form for adult participants in environmental education program activities, capturing health information and emergency contact details.
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Adult Specialist Request
PDF template
Medical referral form for requesting an adult specialist appointment with patient and insurance details.
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Adult Registration Form
PDF template
Comprehensive form for collecting patient personal and insurance information for healthcare purposes.
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Community Practice Referral Form Adult Services
PDF template
A referral form for occupational therapy and physical therapy services for adult patients with various health conditions and treatment needs.
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Volunteer Application Form
PDF template
Comprehensive form for individuals seeking to volunteer at Cape Fear Valley Health System medical facilities.
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NDA Adult Volunteer Registration And Waiver Form
PDF template
A legal waiver form for adult volunteers participating in a neighborhood district association event, releasing the organization from liability.
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ONE YEAR ADVANCED ENDOSCOPY FELLOWSHIP APPLICATION
PDF template
Comprehensive application form for medical professionals seeking a one-year advanced endoscopy fellowship at the University of Missouri's Division of Gastroenterology & Hepatology.
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Provider Appeal Request
PDF template
A form for healthcare providers to submit appeals for denied claims or authorizations with Advanced Health.
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Provider Appeal Request
PDF template
A form for healthcare providers to request an appeal of a denied claim or authorization with Advanced Health.
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Advanced Illness Benefit Application Form
PDF template
Application form for palliative care through the Advanced Illness Benefit for advanced cancer/oncology care by Anglovaal Group Medical Scheme.
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Advance Directive Information Document
PDF template
A comprehensive guide explaining advance directives, their purpose, importance, and how to designate a healthcare agent.
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Service Request Form
PDF template
Medical form for requesting sleep-related diagnostic services and documenting patient sleep disorder symptoms.
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Medical Information And Physician Release
PDF template
A medical form for documenting participant health status and physician clearance for exercise participation at Oregon State University's Adaptive Exercise Clinic.
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AEDBleed Kit Inspection Form
PDF template
A comprehensive inspection form for checking the operational readiness and condition of an AED and associated emergency medical supplies.
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Automated External Defibrillator (AED) Post Incident Report Form
PDF template
A comprehensive form for documenting events involving the use or attempted use of an Automated External Defibrillator at Middle Georgia State University.
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AED Incident Report Form
PDF template
A comprehensive form for documenting and reporting incidents involving the use or attempted use of an Automated External Defibrillator (AED)
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Child Find Referral Form
PDF template
Comprehensive referral form for collecting infant/toddler medical and demographic information for early intervention services.
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REFERRAL FORM
PDF template
Medical referral form for eye-related consultations and treatments in Edmonton, Alberta.
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Referral History And Request Form
PDF template
A comprehensive form for veterinarians to refer animals for specialized medical services and consultations.
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PATIENT INTAKE FORM
PDF template
A comprehensive form for collecting client and pet information for veterinary emergency and specialty care services.
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Prescription Drug Claim Form
PDF template
A comprehensive form for submitting prescription drug claims to Aetna Pharmacy Management for reimbursement or processing.
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Covenant Not To Sue And Indemnity Agreement
PDF template
Legal document waiving liability and assuming risk for participation in Aero Club flying activities.
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Affidavit Of Indigency Form Ohio
PDF template
A legal document used to request a waiver of court fees for individuals who cannot afford legal expenses.
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Active Duty Tour (ADT) Order Request For Military Medical Rotations
PDF template
Official form for military personnel to request and document active duty tour assignments for medical rotations
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Accidental Injury Claim Form
PDF template
Insurance claim form for documenting details of an accidental injury for potential insurance benefits and reimbursement.
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Continuing Disability Claim Form
PDF template
A claim form for filing a continuing disability insurance claim with Aflac, requiring detailed patient and policyholder information.
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Initial Disability Claim Form
PDF template
Insurance claim form for reporting disability due to sickness or injury, used by Aflac for processing disability claims.
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M0272B Flexible Spending Account Claim Form
PDF template
Form for requesting reimbursement from a Flexible Spending Account for medical and dependent care expenses.
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Initial Disability Claim Form
PDF template
Comprehensive form for filing a disability insurance claim covering various types of disability including accidents, sickness, pregnancy, and cancer.
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Sickness Claim Form
PDF template
A comprehensive form for filing insurance claims related to sickness, disability, hospitalization, and other health events with Aflac.
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AFSCME Council 5 Grievance Waiver Form
PDF template
A form used to officially waive rights to pursue a grievance under a collective bargaining agreement
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Adventures In Good Company, Inc. Acknowledgment And Assumption Of Risks Release And Indemnity Agree
PDF template
A legal document outlining participant risks, liability release, and indemnification for Adventures in Good Company (AGC) trips.
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ADVENTURES IN GOOD COMPANY, INC. ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREE
PDF template
Legal document detailing risks, liability release, and participant responsibilities for Adventures in Good Company travel trips.
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AGMA Health Fund Retirement Plan Consent To Electronic Delivery
PDF template
A form allowing members to receive AGMA Health Fund and Retirement Plan notices electronically via email.
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Consent Form For Collecting Personal Data InFrom European Union
PDF template
A consent form for collecting and using personal data from European Union individuals, complying with EUGDPR regulations.
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Services Agreement
PDF template
Agreement for individuals to perform data collection tasks for Datoid's AI research and development, involving text, speech, and media labeling and processing.
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Agriculture Research Animal Transfer Request Form
PDF template
A form for transferring research animals between research protocols and departments, requiring multiple signatures.
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Near Miss Hazard And Incident Reporting Guidelines
PDF template
Comprehensive guidelines for reporting and managing workplace health and safety incidents, near misses, and hazards within an organization.
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Medical Reimbursement Form
PDF template
Form for members to request reimbursement for medical services covered under their health plan
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High Adventure Activity Medical Form
PDF template
A medical form for certifying individual fitness for high-risk adventure activities for youth organizations.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients seeking plastic, reconstructive, or pediatric head and neck surgical services.
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Instructions For Completion Of Application For Specified Service Authority Allied Health Professiona
PDF template
Detailed guidelines for completing an application for medical staff service authority for allied health professionals at Eaton Rapids Medical Center.
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Surgical Booking Request Office Reference Guide
PDF template
A guide for completing the Provincial Surgical Booking Request form to facilitate consistent surgical scheduling and resource allocation.
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Surgical Booking Request Office Reference Guide
PDF template
A comprehensive guide for completing the Provincial Surgical Booking Request form, designed to streamline surgical wait times and resource allocation.
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Arizona Interscholastic Association Annual Preparticipation Physical Evaluation
PDF template
A comprehensive medical screening form for student-athletes to assess their health and fitness for sports participation.
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HYPERSENSITIVITY PNEUMONITIS (HP) PANEL
PDF template
Medical diagnostic form for testing hypersensitivity pneumonitis and avian panel allergens from the Medical College of Wisconsin.
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PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient's personal and family health information, past medical conditions, and surgical history.
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Patient Intake Form
PDF template
A comprehensive form for new patients to provide medical history and contact information for a naturopathic wellness center.
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Advisement And Waiver Of Right To Counsel (Faretta Waiver)
PDF template
Legal form for a criminal defendant to waive their right to an attorney and choose to represent themselves in court proceedings.
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Resident Assessment
PDF template
Comprehensive intake form for documenting a resident's medical history, health status, functional capabilities, and personal information for care facilities.
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ALF Admission Check
PDF template
Comprehensive admission packet for new patients at AMG Senior Medical Group, including patient demographics and consent forms.
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Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
PDF template
A comprehensive medical examination form for athletes to assess physical fitness and health status prior to participation in sports activities.
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Allegations Contained In The StateS Complaint Against Dr. Sun
PDF template
Legal document detailing allegations of inappropriate pain medication prescriptions by Dr. Sun for multiple patients with questionable medical necessity.
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Alfred State Workshop AllergyMedical Form
PDF template
A comprehensive medical form for documenting a camper's allergies, medical conditions, and emergency contact information.
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Springfield Platteview Community Schools Health Examination Form
PDF template
A comprehensive health and immunization form for students in kindergarten through 12th grade in Springfield Platteview Community Schools.
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Allied, Therapeutic And Psychology Extender Benefit Application Form For 2024
PDF template
Application form for healthcare benefit coverage under the Retail Medical Scheme's Essential Plus Option for allied, therapeutic, and psychology services.
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CANCELLATION REQUEST FORM
PDF template
A form used to request cancellation of medical laboratory tests with detailed documentation requirements.
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Participant Accident WaiverRelease Of Liability Form
PDF template
A comprehensive liability waiver for participants in motorcycle events, covering risks, personal fitness, and legal responsibilities.
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ALS Focus Consent Form
PDF template
Online survey platform consent form for people with ALS and their caregivers to participate in research studies about the disease.
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Blue Cross Medical Travel Benefit Claim
PDF template
A claim form for medical travel expenses for members of the Arrow Lakes Teachers' Association submitted to Pacific Blue Cross.
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Transfer Or Discharge Form
PDF template
A form used to document and record the transfer or discharge of a resident from a healthcare facility, including essential transfer details and accompanying documentation.
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Special Holiday Waiver For Security Supervisors Unit, Security Services Unit, Or Agency Police Servi
PDF template
Form allowing security personnel to choose alternative holiday compensation options for Memorial Day, Veterans' Day, and Independence Day 2023
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AAO HNSF 2022 Annual Meeting OTO Experience Call For Science Submission Guidelines
PDF template
Guidelines for submitting scientific presentations to the AAO-HNSF Annual Meeting, including eligibility requirements and speaker responsibilities.
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Nomination For An AMA Award
PDF template
Official form for nominating medical professionals for various American Medical Association awards and recognitions.
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All Musicians Club And Musicians Performance Studio Club Membership Form
PDF template
Membership application and liability waiver for the All Musicians Club and Musicians Performance Studio Club for Laguna Woods Village residents and guests
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MultiCare Auburn Medical Center PGY1 Pharmacy Residency Application Information
PDF template
Application instructions and requirements for PGY1 pharmacy residency at MultiCare Auburn Medical Center
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Medical Examination Report For Bus Transit System Driver
PDF template
Comprehensive medical examination form for bus transit system drivers to assess health conditions and fitness for duty.
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AMERICAN CLUB PRE EMPLOYMENT MEDICAL EXAMINATION FORM2019
PDF template
Comprehensive medical examination form for seafarer pre-employment screening with multiple medical tests and assessments.
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Dental Claim Form
PDF template
A comprehensive form for submitting dental insurance claims, requiring patient and employee information, treatment details, and authorization signatures.
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AMG At Home Admission Check
PDF template
Comprehensive admission checklist and information for patients interested in AMG Senior Medical Group's at-home medical services.
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AMG Requisition Form
PDF template
A form used by surgeons to request amniotic membrane grafts (AMG) from Ramayamma International Eye Bank.
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AMI Insurance Application
PDF template
A comprehensive insurance application form for personal health coverage with options for individual or family plans.
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Student Health Examination Form
PDF template
Medical examination form for students, documenting health history, physical examination, and immunization status.
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Criminal Records Background Check Consent Form For Volunteers
PDF template
Consent form for criminal background checks required for Washington State Department of Natural Resources volunteers with potential access to sensitive environments or populations.
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Individual Volunteer Registration AgreementTime Record
PDF template
Registration and time tracking form for volunteers at the Department of Natural Resources in Washington State
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Guest Speaker Consent Form
PDF template
A legal document allowing American University to record, use, and distribute a guest speaker's presentation and personal information for various purposes.
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MEDIA RELEASE FORM PHOTOGRAPHS ANDOR VIDEO
PDF template
Legal document granting Andrew College permission to use an individual's photographs or video for various purposes
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Angeles New Waiver Forms FAQ
PDF template
Comprehensive guide explaining the Sierra Club's new Participation Agreement, its purpose, usage, and implementation details.
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CYTOLOGY SUBMISSION FORM
PDF template
A detailed form for submitting cytology specimens from veterinary patients to the Angell Lab Pathology Department.
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Animal Incident Report Form
PDF template
A detailed form for reporting animal-related incidents involving bites, scratches, or other exposures to an animal.
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Animal Incident Report Form
PDF template
Official form for documenting animal-related incidents involving potential exposure or injury in Volusia County, Florida.
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Animal Location Inventory
PDF template
A document for recording and tracking animal locations, species, and identification numbers across different rooms.
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Activity Based Risk Assessment Form
PDF template
A comprehensive form for identifying, evaluating, and controlling workplace safety hazards and risks.
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Annual Health Evaluation Form
PDF template
A comprehensive health evaluation form for tracking medical history, lifestyle factors, and current health status.
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Answer And Waiver
PDF template
Legal document in which a respondent acknowledges a divorce petition, waives service of process, and agrees to the petition's terms.
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Member Claim Form
PDF template
Insurance claim form for submitting medical expenses and service details to Anthem Blue Cross health insurance.
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Medical Insurance Claim Form
PDF template
A standard medical insurance claim form for submitting patient information and medical service details to an insurance provider.
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Medical Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare service details and patient information to Anthem Blue Cross insurance.
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Medical Claim Form
PDF template
A comprehensive form for submitting medical insurance claims, collecting patient, subscriber, and medical service information.
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Medical Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare service reimbursement claims to Anthem Blue Cross and Blue Shield insurance.
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Medical Claim Form
PDF template
A standard medical insurance form for submitting healthcare service claims and patient information to an insurance provider.
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Waiver Of The Service Of Summons
PDF template
Legal document allowing a defendant to waive formal service of a summons in a civil court action, simplifying legal notification process.
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AO 399 Waiver Of The Service Of Summons
PDF template
Legal document allowing a defendant to waive formal service of a summons in a civil court action, reducing service expenses.
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AO Alliance (AOA) ORP Fellowship Application Form
PDF template
Application form for medical professionals seeking a fellowship with the AO Alliance in orthopedic and trauma surgery
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AO Alliance (AOA) Surgeon Fellowship Application Form
PDF template
Application form for surgeons seeking a fellowship with the AO Alliance, requiring detailed professional and personal information.
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COVID 19 Assumption Of The Risk Forms
PDF template
Proposal for risk mitigation forms to address COVID-19 exposure in fraternity settings, covering various participant types.
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Assumption Of The Risk And Hold Harmless Agreement
PDF template
Legal document outlining risk assumption and liability waiver for contractors working in a fraternity chapter facility.
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Notice Of Voluntary Resignation Form
PDF template
A formal document for an employee to voluntarily resign from their position at Tremonton City, including legal waivers and acknowledgments.
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Form CS5 STUDENT ACCEPTABLE USE OF TECHNOLOGY AGREEMENT
PDF template
A consent form outlining technology usage rules and expectations for students in grades 7-12 at a Catholic school district.
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Release And Waiver Of Liability Form
PDF template
Liability waiver for students enrolled in De Anza College's adapted swimming courses, outlining participation requirements and risk assumptions.
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PARTICIPANT MEDICAL HISTORY FORM
PDF template
Confidential medical history form for collecting participant health information for trips and activities by APEX
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Medical Information Release Form
PDF template
A form allowing parents or legal guardians to specify who can receive medical information about their child from Angelina Pediatrics, PLLC.
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Tuberculosis Case Management Manual
PDF template
A comprehensive manual providing guidelines, resources, and forms for tuberculosis case management in Missouri.
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Appendix 5 Medical Release Form
PDF template
A medical release form for seniors participating in the Community Healthy Activities Model Program, allowing notification of primary care physician.
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NSW Health UndertakingDeclaration Form
PDF template
Form for health workers and students to declare compliance with infectious disease screening and vaccination requirements for NSW Health facilities.
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RELEASE, WAIVER OF LIABILITY, COVENANT NOT TO SUE
PDF template
Legal document releasing Columbus State University from liability for potential injuries during a camp or conference event.
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Institutional Drug Testing Program Student Athlete Notification Form
PDF template
A form documenting the notification and consent process for student-athletes selected for mandatory drug testing.
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NAPNAP Faculty Declaration Form
PDF template
A form for presenters to declare potential financial conflicts of interest and off-label drug or medical device discussions.
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Eparchial PhotoVideoMedia Release Form
PDF template
A consent form for photographing and using images of individuals at events organized by the Ukrainian Catholic Eparchy of Saskatoon.
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Appendix T San Diego Police Department Crime Laboratory Feedback Form
PDF template
A detailed evaluation form for forensic evidence collection and assessment during a medical forensic examination.
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Applicant DrugAlcohol Testing Consent Form
PDF template
Consent form for drug and alcohol testing as a condition of employment with Global Packaging, Inc.
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Consent To Reference And Background Check Form
PDF template
Legal authorization form allowing an employer to conduct background checks and reference verifications on a potential or current employee.
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11F ApplicantS Waiver Form (Collegiate Only)
PDF template
A form for collegiate applicants to waive providing information to their parents/guardians during the sorority membership intake process.
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Charitable Trust Of The Auckland Faculty Royal New Zealand College Of General Practitioners Applicat
PDF template
Comprehensive assessment form for evaluating research grant applications from general practitioners in New Zealand.
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APPLICATION FEE WAIVER FORM
PDF template
Form to request waiver of civil service examination application fees for unemployed individuals or those receiving public assistance.
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Application For Credit By Examination
PDF template
Official form for students seeking to earn academic credits through examination in the Department of Languages and Literatures of Europe and the Americas.
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FHNO Institutional Fellowship Application Form
PDF template
Application form for fellowship in Head and Neck Oncology/Reconstructive Surgery with comprehensive applicant details collection.
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APPLICATION FOR MILITARY SKILLS TEST WAIVER
PDF template
Form for qualified service members to apply for a Commercial Driver License (CDL) waiver based on military vehicle operation experience.
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FORM AFULL RESEARCH REVIEW APPLICATION FORM (IRB)
PDF template
A comprehensive form for submitting research projects involving human subjects for institutional review and approval.
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Medical Appeals And Reinstatements Sections 717273
PDF template
Comprehensive guide for NYC employees seeking medical reinstatement, detailing required documentation and submission procedures.
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STUDENT INCIDENT REPORT FORM
PDF template
A comprehensive form for documenting student incidents, including details of the event, student's account, and additional comments from faculty or preceptors.
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Appointment Consent Form
PDF template
A consent form allowing another person to sit in on a student's appointment and access sensitive academic and financial information.
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Functional Medicine Clinic Appointment Time Agreement
PDF template
Agreement outlining fees and policies for patient appointments, including no-show and late cancellation charges.
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Course Waiver Form
PDF template
A form allowing students to request exceptions to standard course enrollment requirements such as prerequisites, class restrictions, and time conflicts.
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APPs In The Research Setting A Checklist For Researchers
PDF template
A comprehensive guide for researchers to evaluate legal and ethical considerations when developing or using mobile applications in research studies.
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Teacher Program Agreement Media Release Form
PDF template
A document for teachers participating in UCLA's AP Readiness Program, including program commitment and media release consent.
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NH Medicaid To Schools Billing Companion Guide Update
PDF template
Guidance document from New Hampshire Medicaid providing clarifications on billing, parental consent, and provider requirements for school-based Medicaid services.
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AQUATIC SUBMISSION FORM
PDF template
A form for submitting aquatic species specimens for health and diagnostic testing at Indiana Animal Disease Diagnostic Laboratories.
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OCCUPATIONAL MEDICAL SURVEILLANCE PROGRAM PHYSICAL EXAMINATION FORM
PDF template
A comprehensive medical examination form for documenting employee health status and physical condition for the United States Department of Agriculture.
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ARCHERY CLUB EMERGENCY CONTACT RECORD
PDF template
A detailed emergency contact and medical information form for participants in the Wilton Family Y Archery Club.
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Remdesivir Prescribing DeclarationStreamlined IPU Application Form
PDF template
A form for healthcare professionals to request and prescribe Remdesivir for COVID-19 patients meeting specific criteria.
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Arizona SPDSCLUE Waiver Form
PDF template
A form allowing buyers and sellers to waive property disclosure statement and insurance claims history report in a real estate transaction.
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Recommended Finish Floor Elevation Affidavit
PDF template
A document for property owners acknowledging flood risk information and recommended floor elevation based on FEMA Base Level Engineering data.
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Legacy Tuition Waiver Form
PDF template
A form allowing non-resident students to receive resident tuition rates if a family member graduated from Wichita State University.
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Submission Usage Agreement With The Art Of Autism Website And Affiliated Sites, Social Media And New
PDF template
A legal agreement for artists submitting artwork to The Art of Autism, outlining usage permissions and submission guidelines.
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Math And Science Prerequisite Waiver Form
PDF template
Form for students seeking to waive math and science course prerequisites at Macomb Community College
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Alexandria Soccer Association Medical Release Form
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A medical authorization form allowing team officials to obtain medical attention for a child during soccer activities.
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Consent Form For Participation In A Research Study
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Informed consent document for a research study involving a stressful computer task with potentially disturbing visual stimuli.
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Central Registry Referral Form
PDF template
A referral form for documenting spinal cord injury or disability cases for the Arkansas Spinal Cord Commission's central registry.
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ICARUS MEDICAL, LLC ORDER FORM
PDF template
Order form for custom knee braces with patient and measurement information.
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Referral Form
PDF template
Medical referral form for new patient intake and treatment evaluation at Ascend Health Center, focusing on mental health services.
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Assumption Of Risk, Waiver, Release And Indemnity Agreement
PDF template
Legal document outlining risks and liability for participation in various recreational activities at the Anne Springs Close Greenway.
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ASE Organizational Membership Application
PDF template
Organizational membership application for multiple members from the same institution to join or renew ASE membership with various professional categories and pricing tiers.
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ASE Membership Application Form
PDF template
Organizational membership application form for joining or renewing membership in the American Society of Echocardiography with various membership categories and pricing.
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Liability Waiver Form For ASF Members
PDF template
A legal document waiving liability for children participating in activities at Scandinavia House Children's Center and authorizing emergency medical treatment.
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ASIIS Enrollment Application
PDF template
Application for organizations to enroll in the Arizona State Immunization Information System (ASIIS) for healthcare providers and facilities.
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High Risk Waiver Form
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A consent form for pet owners acknowledging surgical risks and agreeing to proceed with spay/neuter surgery despite medical concerns.
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MEDICALVISION CLAIM FORM
PDF template
A comprehensive claim form for submitting medical and vision insurance claims, requiring detailed employee and patient information.
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COVID 19 Assumption Of The Risk Forms
PDF template
Comprehensive guidance for creating risk assumption forms to address COVID-19 exposure in fraternity settings, with five different versions for various participant types.
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Asthma Assessment Form For School
PDF template
Comprehensive form to collect detailed medical information about a student's asthma symptoms, triggers, and management for Seattle Public Schools.
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Athlete Emergency Contact Form
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A form for collecting student athlete emergency contact details and medical conditions for use by school athletic department personnel.
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Special Olympics Medical Form
PDF template
Comprehensive medical form for Special Olympics athletes documenting health history, conditions, and participation details.
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Special Olympics Medical Form
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Medical examination form for determining an athlete's fitness to participate in Special Olympics sports programs, requiring medical professional evaluation.
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Athletic Emergency Contact Form
PDF template
A comprehensive form collecting medical, contact, and emergency information for student athletes.
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WCGS Athletics Travel Permission Form 2022 2023
PDF template
A consent form for parents of student athletes allowing transportation and medical authorization for off-campus sports events
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Melba Schools Activity Policy
PDF template
Comprehensive policy document covering insurance waiver, drug testing consent, and activity participation guidelines for Melba School District students.
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Athletic Travel Form
PDF template
A comprehensive form for student-athletes detailing emergency contact information, medical details, and consent for medical treatment during athletic participation.
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General Release Form For PhotographyVideographyAudio Recording
PDF template
A legal document granting A.T. Still University permission to use an individual's likeness, voice, and personal information for educational and promotional purposes.
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General Release Form For PhotographyVideographyAudio Recording Child
PDF template
A legal document granting A.T. Still University permission to record and use a child's likeness, voice, and name for educational and promotional purposes.
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MedicalForensic Examination Form
PDF template
A detailed forensic medical examination form for documenting physical findings in sexual assault cases, covering body diagrams and genital examination for both female and male patients.
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Waiver Service Request Form (DP 1022)
PDF template
A form for requesting changes or new services in a waiver program, to be completed when team concurrence is not achieved.
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Data Protection Consent Form
PDF template
Consent form for members to agree to data usage, publication of contact details, team information, and photography by the Ashford Table Tennis Club.
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Bishop Canevin Attendance Notice
PDF template
Official school document for recording student absences, tardiness, early dismissals, and medical appointments.
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MINOR YOUTH EMERGENCY MEDICAL CONTACT, HEALTH HISTORY AND TREATMENT AUTHORIZATION
PDF template
A comprehensive medical contact and health authorization form for minors participating in a program, collecting emergency contacts, health information, and parental consent for medical treatment.
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Attending PhysicianS Compliance Form
PDF template
Medical form documenting physician compliance and patient consent for end-of-life medication request in the District of Columbia.
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Long Term Disability Claim Form
PDF template
A comprehensive medical form for documenting a patient's disability claim, including medical history, diagnosis, treatment, and current condition.
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West Kentucky ATV Recreational Area Release And Waiver Of Liability And Indemnity Agreement
PDF template
Legal document releasing liability for participants entering and using the West Kentucky ATV Recreational Area for off-highway vehicle riding.
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Consent To Use Sound And Image Recordings That May Contain Identifying Information For Education
PDF template
A consent form allowing physicians to use patient images and sound recordings for educational purposes with patient's understanding of potential identification.
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IHS Diabetes Care And Outcomes Audit, 2024
PDF template
A comprehensive audit form for tracking diabetes patient health metrics, screenings, and examinations
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Patient Intake Form
PDF template
Comprehensive patient intake form for collecting personal, contact, and medical insurance information at Auburn University Clinical Health Services clinics.
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Universal Service Request Form
PDF template
Form for comprehensive employee medical examinations, drug testing, and workplace health screening documentation.
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MEDIA, PHOTO VIDEO RELEASE FORM
PDF template
A legal document granting Assumption University rights to use student/participant images and recordings for various university purposes.
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Overseas Travel Risk Assessment Form
PDF template
A comprehensive form for Aberystwyth University staff to assess and document risks associated with international business travel.
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HOLD HARMLESS, VOLUNTARY WAIVER, AND ASSUMPTION OF RISK FORM
PDF template
A legal document that releases Auburn University from liability for potential injuries or damages during a field trip event.
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Request For Completion Of USDA Identity Declaration
PDF template
A form for veterinarians and exporters to complete identity verification for pets traveling to Australia.
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CONSENT FOR AUTHORIZATION FOR USERELEASE OF HEALTH INFORMATION
PDF template
A consent form allowing the release of protected health information to a specified recipient with specific conditions and understanding of potential sensitive data disclosure.
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Authorization For The Release Of InformationPrivacy Act Notice
PDF template
A consent form authorizing HUD to verify income, employment, and financial information for housing assistance programs.
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WaiverAuthorization Form
PDF template
A legal liability waiver for participants in Keep Florence Beautiful community activities and events.
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Authorization Form
PDF template
A form authorizing specific individuals to make medical decisions and perform actions related to a pet's care and treatment.
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Authorization Form For The Use And Disclosure Of Patient Health Information For Research Purposes
PDF template
A consent form allowing researchers to use and disclose patient health information for a specific research study at the University of Wisconsin - Milwaukee.
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Williamson County Schools Procedure Authorization Form
PDF template
A form for authorizing medical procedures to be administered to a student during school hours, requiring physician and parental consent.
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Customer Consent Form Other Than CeUD
PDF template
A form allowing customers to authorize one-time release of specific personal information to third parties by Xcel Energy.
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HIV Related Information Release Authorization Form
PDF template
Legal form authorizing release of medical and HIV-related information under New York State confidentiality laws
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Authorization Form For Use Or Disclosure Of Protected Health Information
PDF template
A form allowing authorization for use or disclosure of an individual's protected health information by Sedgwick County.
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Authorship Agreement Form
PDF template
A form documenting individual contributions and authorship criteria for academic or medical research publications.
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Autism Emergency Contact Form
PDF template
A comprehensive emergency contact and personal information form for individuals with autism, designed to assist in case of emergencies or potential wandering incidents.
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Autism Emergency Contact Form
PDF template
A comprehensive form collecting critical personal and medical information for individuals with autism in case of emergency or potential wandering incidents.
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Autism Profile And Emergency Contact Form
PDF template
A comprehensive form for documenting critical medical, contact, and behavioral information for individuals with autism
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New PIP Patient Form
PDF template
Detailed form for documenting vehicle accident details and patient information for insurance or medical purposes.
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AVDL Submission Form CF.ACC.1.10
PDF template
A submission form for veterinary diagnostic sample submissions to the Alabama Veterinary Diagnostic Laboratory System.
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Avera EConsult Assessment Form
PDF template
A comprehensive medical assessment form for telemedicine patient consultations, capturing patient information and physical examination details.
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Animal Workers Medical Surveillance Consent For Medical ScreeningEvaluation
PDF template
A consent form for medical screening and evaluation of individuals working with animals at the University of Idaho.
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Medical Expense Claim Form
PDF template
A form for employees to claim medical expenses through a Flexible Spending Account with detailed submission instructions.
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Alfond Youth Community Center New England Sports Camps Medical History Form 2023
PDF template
Comprehensive medical history and emergency contact form for children attending various sports camps in Maine.
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Patient Authorization Form
PDF template
A form authorizing AstraZeneca to use and share patient health information for support services and coordination of care.
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Member Request For Medical Reimbursement Form
PDF template
A form used by UnitedHealthcare Community Plan members to request reimbursement for medical services, co-payments, coinsurance, and deductibles.
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Comptroller General Decision B 156482
PDF template
Official decision denying a former government employee's request to waive salary overpayments due to an erroneous personnel record.
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Background Check Consent Form
PDF template
A consent form allowing an employer to conduct background investigations and consumer reports on a potential or current employee.
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Chesapeake Public Schools ParentGuardian Media Release Form For Students
PDF template
A form granting permission for students to be photographed, recorded, or videotaped for school-related media purposes.
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Build America, Buy America Act (BABAA) Domestic Content Procurement Preference Requirements Waiver
PDF template
A form for requesting a waiver from the Build America, Buy America Act domestic content procurement preference requirements for U.S. Department of Education grants.
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Background Check Consent Form
PDF template
Consent form for background checks for volunteers and employees at Archbold United Methodist Church.
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Employment Application Addendum
PDF template
A consent form for employment background checks that authorizes investigation of personal, professional, and financial history.
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AUTHORIZATION FOR TDPS BACKGROUND CHECK CONSUMER REPORT
PDF template
A consent form authorizing Collin County Community College District to obtain criminal background and consumer reports from Texas Department of Public Safety and ChoicePoint WorkPlace Solutions Inc.
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Background Check Consent Form
PDF template
A consent form for employees and volunteers to authorize a background check as part of the onboarding process at NYU Langone Medical Center.
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Background Check Consent Form
PDF template
A consent form for criminal background check authorization, typically used for employment or volunteer screening in a church or ministry setting.
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Employee Consumer Authorization And Consent Release
PDF template
A document authorizing Undercroft Montessori School and Gallant Background Checks LLC to conduct a comprehensive background investigation for employment purposes.
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Background Check Consent Form
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A consent form allowing a ministry to conduct background checks on potential volunteer mentors, with acknowledgment of potential disqualifying factors.
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CONSENT FOR CRIMINAL BACKGROUND CHECK
PDF template
A form authorizing a criminal background investigation and consent for information verification from law enforcement and court agencies.
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Criminal Background And Sex Offender Check Disclosure And Consent Form
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A form authorizing criminal background and sex offender checks for volunteers seeking to work with KIPP DC students.
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National Background Screening Consent Form
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A consent form allowing an organization to conduct comprehensive background checks on an applicant, including criminal records, sex offender registries, and identity verification.
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National Background Screening Consent Form
PDF template
Consent form for comprehensive background screening covering criminal records, sex offender registries, and personal information verification.
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Consent To Perform A HistoryBackground Check
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A consent form for conducting criminal history background checks for employment or volunteer positions at Denton Calvary Academy.
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Background Check Consent Form
PDF template
A comprehensive form for collecting personal and biographical information for employment or screening purposes.
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Background Check Consent Form
PDF template
Consent form for criminal background checks for Boy Scouts of America employees, administrators, and volunteers in California.
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Background Check Consent Form
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Form for obtaining consent and conducting background checks for individuals seeking pastoral ministry positions in the South Georgia Annual Conference.
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Duchesne County School District Background Check Consent Form
PDF template
A consent form for conducting criminal history records search for job applicants or volunteers with Duchesne County School District
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Background Check Consent Form
PDF template
A consent form allowing South Haven Baptist Church to conduct background investigations for volunteers and employees.
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Background Check Consent Form
PDF template
A consent form allowing criminal history record disclosure for a non-profit organization's application process.
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Criminal Background Check Consent Form
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A consent form for conducting a criminal background check by the City of Freeport, Minnesota, requiring personal identification and authorization for record disclosure.
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Informed Consent (123B.03) Volunteer Form
PDF template
Consent form for volunteers at Heartland Christian Academy allowing criminal background check and record disclosure.
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Background Check Consent Form
PDF template
A government form for collecting personal details and consent for background verification purposes.
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CRIMINAL BACKGROUND CHECK CONSENT FORM
PDF template
Consent form allowing Turner's Landscape Inc. to conduct a criminal background investigation for employment purposes.
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Authorization For Release Of Information Background Check Consent Form
PDF template
A consent form authorizing First Advantage to conduct a comprehensive background investigation for employment purposes.
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Adjacent Property Owner Consent Form For Backyard Chickens
PDF template
A form requiring consent from adjacent property owners for obtaining a permit to keep backyard chickens in Winter Park, Florida.
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My Choice Wisconsin BadgerCare Plus Authorization Form
PDF template
A comprehensive form for requesting healthcare service authorizations under the BadgerCare Plus program in Wisconsin.
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Laurel High School Marching Band Medical Form
PDF template
Medical form for Laurel High School Marching Band students to provide health and emergency contact information for band activities.
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Medical History Form
PDF template
A comprehensive medical history form for collecting student health information, emergency contacts, and family medical history.
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Bangs Ambulance Events Request Form
PDF template
Form for requesting ambulance and medical support services for events with specific scheduling details.
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Chronic Appliance Benefit Application Form
PDF template
Medical application form for patients seeking insurance coverage for chronic medical appliances and equipment through Bankmed.
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Medical History Form
PDF template
Comprehensive medical history form for patients seeking weight loss treatment, collecting personal, medical, and insurance information.
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Health Is Wealth Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient personal, employment, emergency contact, and insurance information.
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Baseball Medical Release Form
PDF template
A medical authorization and consent form for baseball participants, allowing medical treatment and acknowledging potential risks of participation.
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Health Care Personnel (HCP) Baseline Individual TB Risk Assessment
PDF template
A screening form to assess tuberculosis risk factors for healthcare personnel through a series of yes/no questions about travel, immunosuppression, and TB exposure.
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City Of Omaha Hazard Risk Assessment
PDF template
A comprehensive risk assessment document for identifying potential workplace hazards, their severity, likelihood, and control measures.
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St. Ignatius Basketball Camp Liability Waiver Form
PDF template
Liability waiver and emergency contact form for participation in St. Ignatius Basketball Camp for student-athletes.
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ACHD Bathing Place Incident Report Form
PDF template
A comprehensive form for reporting incidents and injuries at public bathing facilities, including water rescues and medical treatments.
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BAT SUBMISSION FORM
PDF template
A form for reporting bat encounters and potential exposure, used by veterinary clinics and animal shelters to notify Public Health about bat specimens.
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ANIMAL SHELTER INSPECTION FORM
PDF template
Official form used by Virginia Division of Animal & Food Industry Services to conduct animal shelter inspections and record facility compliance.
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VolunteerParental Consent Form
PDF template
Legal document outlining volunteer responsibilities, liability waivers, and consent for volunteering at Bernie's Book Bank, including provisions for minor volunteers.
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Liability Media Release Form
PDF template
A release form for parents/guardians to authorize child participation in music school programs and grant media usage permissions.
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BC3NP Enrollment Form
PDF template
Healthcare enrollment form for collecting patient contact, demographic, and service needs information.
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Sport Injury Accident Report Form
PDF template
A comprehensive form for documenting sports-related injuries or accidents during an event, capturing details about the injured person and medical response.
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Sexual Assault Evidence Testing And Storage Consent Form
PDF template
A form for sexual assault survivors to choose between unrestricted forensic testing or restricted kit storage with law enforcement.
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Patient Insurance Information Form
PDF template
Comprehensive form for collecting patient medical insurance and health coverage details for claims processing.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive insurance claim form for documenting medical treatment, injury, or preventive care for reimbursement purposes.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient details, treatment information, and other coverage details.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive insurance claim form for submitting medical treatment claims with detailed patient and treatment information.
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Educators Health Alliance Medical And Dental Enrollment Form
PDF template
A medical and dental insurance enrollment form for Educators Health Alliance, allowing new applications and changes to existing coverage.
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Member Reimbursement
PDF template
A form for members to request reimbursement for healthcare expenses paid out-of-pocket directly to providers.
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SNFAcute IPR Assessment Form
PDF template
Prior authorization form for skilled nursing facility and inpatient rehabilitation services for Blue Cross Blue Shield of Michigan and Blue Care Network providers.
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Member Reimbursement
PDF template
A form for Blue Cross Blue Shield members to request reimbursement for healthcare expenses paid out of pocket.
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Medical Expense Claim
PDF template
A claim form for submitting medical expenses to Blue Cross and Blue Shield of Alabama for reimbursement.
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Member Reimbursement
PDF template
Form for members to request reimbursement for healthcare expenses paid out-of-pocket.
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Member Claim Form
PDF template
A form for filing healthcare claims with Blue Cross Blue Shield of North Carolina, detailing patient and insurance information for reimbursement of medical services.
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Western Carolina University Base Camp Cullowhee Health And Medical Form
PDF template
A health screening form for participants in outdoor activities, collecting medical history and emergency contact information.
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My Benefit Plan Summary
PDF template
Comprehensive health benefits summary for full-time employees of Brant Community Healthcare System through Green Shield Canada.
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ADPH F BCL 136 Alabama Department Of Public Health (ADPH) Bureau Of Clinical Laboratories (BCL) Requ
PDF template
A comprehensive laboratory testing request form used by healthcare providers to submit patient specimens for clinical testing in Alabama.
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Member Billing Form
PDF template
A form for submitting medical bills from non-participating healthcare providers for reimbursement or claim processing.
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Member Reimbursement Form
PDF template
A form for healthcare members to request reimbursement for out-of-pocket medical expenses they have paid directly.
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MEDICAL INFORMATION FORM
PDF template
A comprehensive medical form for participants of outdoor adventure trips, collecting health, emergency, and medical history information.
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Background Check Consent Form For Candidates For Public Office Positions
PDF template
A comprehensive form for collecting personal and professional information for candidates seeking public office positions, including consent for background verification.
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BDIAP Glasgow 2020 Educational Fellowship Application Form B
PDF template
Application form for medical or scientific professionals seeking an educational fellowship with the British Division of the IAP in Glasgow
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Physical Examination Form
PDF template
A comprehensive medical form for documenting a student's physical health assessment by a healthcare provider.
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Ancillary Order Form
PDF template
A medical form for ordering orthotic services, therapy, and documenting patient diagnostic information.
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LANDOWNER CONSENT FORM
PDF template
A form granting permission for authorized personnel to access private property to address public health and safety risks from beaver or muskrat populations.
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Beazley Financial Institutions Directors Officers Proposal Form
PDF template
A comprehensive proposal form for financial institutions seeking Directors & Officers liability insurance coverage, requiring detailed company information and ownership details.
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MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal information, medical history, insurance details, and current health status.
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BEHAVIOR ASSESSMENT FORM
PDF template
A comprehensive form for evaluating an animal's behavior, temperament, and social responses in a veterinary or animal welfare context.
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M NCPPC BENEFITS ENROLLMENTCHANGE FORM
PDF template
Form for employees to enroll or change benefits, covering medical, dental, and prescription plans for new hires or those experiencing qualifying life events.
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Informed Consent, Voluntary Waiver, Release Of Liability, Assumption Of Risk, And Photography Releas
PDF template
Legal document for parental consent and liability release for child participation in a program at Bethel University
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Gift Aid Declaration FormGeneral Data Protection Consent Form
PDF template
A form for UK taxpayers to declare gift aid donations and provide data protection consent for the Bexhill CAP Centre charity.
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2023 2024 Beyfortus Medication Consent Form
PDF template
Medical consent form for Beyfortus (Nirsevimab) RSV preventative antibody for children under 8 months old
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BOISE FIRE DEPARTMENT MEDICAL RELEASE FORM
PDF template
Medical form for evaluating and releasing firefighters to full duty after injury or medical assessment.
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Health Savings Account Transfer Request Form
PDF template
A form for transferring health savings account assets from a previous trustee/custodian to Benefitfocus Account Services HSA.
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Discharge Form
PDF template
A form used to document and track patient discharge details for behavioral health clinical services.
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Patient Medical History Form
PDF template
Comprehensive medical history form collecting patient's personal health information, medical history, symptoms, and current health status.
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Media Release Form
PDF template
Legal document granting permission to use an individual's name, image, and likeness for media purposes without financial compensation.
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FederalDOT Testing Form
PDF template
Comprehensive medical screening and drug testing form for transportation workers requiring federal agency compliance.
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TELEHEALTH CONSENT FORM FOR MENTAL HEALTH SERVICES
PDF template
A consent form detailing the terms, risks, and responsibilities for receiving mental health services via telehealth technology.
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Histology Service Request Form
PDF template
A form for requesting histology services including tissue processing, embedding, staining, and immunohistochemistry for human or animal biospecimens.
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Oncology Prescription Referral Form
PDF template
A comprehensive form for submitting oncology patient prescription details, insurance information, and clinical data for medication authorization.
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Biometric Identifier Collection Authorization Form
PDF template
Authorization form for collecting and using fingerprint data for facility access control at Northwestern University.
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Patient Intake Form
PDF template
Comprehensive medical form for collecting patient personal, contact, medical, and insurance information with consent authorization.
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Harvard University Biosafety Manual
PDF template
Comprehensive guide for laboratory safety protocols, biosafety levels, and procedures for handling biological materials at Harvard University.
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Release And Assumption Of Risk Form
PDF template
Legal document releasing the Bermuda Institute of Ocean Sciences from liability during scientific, research, or recreational activities.
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Veterinary Public Health Rabies Control Program Report Form
PDF template
A comprehensive form used to report suspected rabid animals, animal bites, and track potential rabies exposure incidents.
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ANIMAL BITE REPORTING FORM
PDF template
A form for documenting details of an animal bite incident, including victim and animal information for public health tracking.
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Domestic Vs Wild Mammal Incident Report Form
PDF template
Form for reporting domestic and wild mammal interactions, primarily used to track potential rabies exposure incidents in Los Angeles County.
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Consent For Employee Background Check
PDF template
A consent form authorizing Messiah University to conduct pre-employment background checks and verify employment-related information.
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Credit Card Pre Authorization Form
PDF template
A form authorizing The Viva Center to charge credit card for services with pre-approved billing parameters.
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Event Risk Assessment Form
PDF template
A comprehensive form for assessing potential risks and gathering details for events not reserved through the online reservation system.
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PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting patient health information, medical history, and current health status.
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RISK ASSESSMENT FORM
PDF template
A comprehensive document for identifying workplace hazards, assessing risks, and determining control measures across multiple potential risk areas.
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Official Travel Request Form
PDF template
Comprehensive travel request form for participants, volunteers, and staff to provide travel details and personal information for a trip.
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Blood Body Fluid Exposure Report
PDF template
A form documenting blood or body fluid exposure incidents for students, tracking medical testing and follow-up procedures.
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Blood Drive
PDF template
Blood donation drive organized by American Red Cross at Mt. San Antonio College to collect blood donations.
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TEST REQUEST
PDF template
A comprehensive medical test request form for collecting patient information and specifying various laboratory tests to be performed.
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Health Insurance Claim Form
PDF template
Comprehensive form for collecting patient medical insurance information, health coverage details, and claim submission details.
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Blue Cross Blue Shield Insurance Claim Form
PDF template
A comprehensive medical insurance claim form for collecting patient and insurance information for medical service reimbursement.
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Member Claim Form
PDF template
A comprehensive medical claim form for submitting healthcare service expenses to Anthem Blue Cross insurance.
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Enrollment And Change Form
PDF template
Healthcare insurance enrollment and change form for selecting medical and dental coverage options through Blue Cross Blue Shield
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Santa Monica College Confidential Medical History
PDF template
A comprehensive medical history form for students to document personal health information and medical background.
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Emergency Contact Form
PDF template
A form for collecting emergency contact information and obtaining informed consent for exercise participation in a WICT event
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Bert Miller Nature Club Waiver
PDF template
Annual waiver form for Bert Miller Nature Club members and guests to acknowledge risk and provide emergency contact information.
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Application For Skills Test Waiver Military Exception
PDF template
A form allowing qualified military service members to apply for a Commercial Driver License (CDL) without skills testing under specific conditions.
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Application For Skills Test Waiver Military Exception
PDF template
A form allowing military service members to apply for a Commercial Driver License (CDL) waiver based on their military vehicle operation experience.
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PIERCING CONSENT RELEASE FORM
PDF template
A legal consent form outlining risks, expectations, and patient acknowledgment for body piercing procedures.
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Termination Of Membership Form
PDF template
A form for members to officially resign from the Bonitas Medical Fund and terminate their medical scheme membership.
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Book Order Form
PDF template
Order form for a commemorative book about the Michigan Society of Thoracic and Cardiovascular Surgeons' history.
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Ventura County Wellness Program Waiver Form
PDF template
A waiver form for voluntary participation in a county wellness fitness program, detailing recreational activity liability and health considerations.
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ParentalGuardian Consent Form
PDF template
A consent form for parents/guardians to authorize minors under 18 to apply for a student pharmacy technician registration in Idaho.
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BostonSight (HIPAA) MEDICAL RECORDS RELEASE FORM
PDF template
A form that allows patients to grant permission for BostonSight to share their medical information with specified individuals or organizations.
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Suspect Foodborne Or Unknown Etiology Botulism Case Interview Form
PDF template
A detailed medical form for collecting comprehensive information about a potential botulism case, including patient demographics, clinical information, and medical history.
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Suspect Foodborne Or Unknown Etiology Botulism Case Interview Form
PDF template
A detailed medical form for collecting comprehensive information about a potential botulism case, including patient demographics, clinical information, and medical history.
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License Authorization Form
PDF template
A form for medical facilities to authorize product ordering and certify licensing for prescription drugs, medical devices, and controlled substances.
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Bovine Submission Form
PDF template
A comprehensive form for submitting bovine animal samples for veterinary diagnostic testing and necropsy services.
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Camp Medical Form
PDF template
A medical form for parents/guardians to provide health information and medical history for children attending summer camp.
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AMWA Branch Annual Report Form
PDF template
Annual reporting form for branches of the American Medical Women's Association to document branch activities and leadership
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RELEASE, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
PDF template
Legal document for releasing liability and obtaining consent for YMCA program participation and activities.
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BRASSEl Pilar Program Medical Form
PDF template
Confidential medical history form for participants in an archaeological research program at El Pilar, collecting personal health information and emergency contact details.
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Patient Medical Referral Form
PDF template
Comprehensive medical referral form capturing patient demographics, diagnostic information, and key health metrics
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Medi Cal To Healthy Families Bridging Consent Form
PDF template
A consent form allowing transfer of Medi-Cal case file information to the Healthy Families Program for low-cost health coverage for children.
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The Bridge Program Media Release Form
PDF template
Document allowing or declining consent for media recording and usage by the University of Mississippi's Bridge Program.
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Patient Intake Form
PDF template
Comprehensive form for collecting patient and family medical contact information for pediatric medical practice.
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BritainS Got Talent 11 Audition Release Form
PDF template
Official release form for participants auditioning for Britain's Got Talent and Britain's Got More Talent television programs
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RHIO CONSENT FORM
PDF template
A consent form allowing patients to choose whether to share their medical records electronically through the Bronx RHIO, Inc network.
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BRYC Elite Academy Medical Release Form
PDF template
A medical consent form allowing treatment for a youth athlete in case of injury or medical emergency during sports activities.
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Informed Consent, Release Agreement, And Authorization
PDF template
A comprehensive consent and medical authorization document for participating in Scouting activities, covering emergency medical treatment and risk acknowledgment.
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LOEWENBERG SCHOOL OF NURSING HEALTH EXAMINATION FORM (FORM 003)
PDF template
Comprehensive health history and screening form for nursing students to document medical background and potential health concerns.
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Waiver Application Form
PDF template
Application for local educational agencies seeking to reopen elementary schools for in-person instruction during COVID-19 pandemic.
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REQUISITION FORM
PDF template
A form for patient information, billing details, and physician consent for medical testing by BillionToOne.
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Budget Form Training To Competence Externship
PDF template
A budget form for applicants seeking funding for an externship program, requiring detailed expense documentation and submission at least one month prior to start date.
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Budget Form Reproductive Health Externship Clinical Abortion Observation
PDF template
A form for medical students to document and request funding for expenses related to a reproductive health externship or clinical abortion observation program.
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High Risk Consent Form
PDF template
Consent form for pet owners acknowledging medical risks and financial responsibility for surgical procedures with high-risk patients.
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BUILDING HEALTH AND SAFETY RISK ASSESSMENT FORM
PDF template
A comprehensive form for identifying and assessing potential hazards and risks in a building environment.
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BuildOn Medical Form
PDF template
A comprehensive medical form for participants traveling to do physical labor in a remote community, focusing on detailed health history and potential medical risks.
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Proper Use Of The Official Waiver Of Standards Form
PDF template
A guide explaining the use of the Official Waiver of Standards Form for termite treatments in South Carolina, detailing regulatory changes and requirements.
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Accident Waiver And Release Of Liability Form And Photo Release
PDF template
Legal document waiving liability for participants in a recreational event, covering potential risks and injuries.
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OVERSEAS TAVEL RISK ASSESSMENT FORM
PDF template
A comprehensive form for staff and students to assess risks associated with international travel to high-risk areas.
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Burglary Insurance Proposal Form
PDF template
An insurance proposal form detailing coverage, exceptions, and terms for burglary insurance by M & C General Insurance Company Ltd.
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Prime Contractor Waiver Form
PDF template
A form for contractors to document their business equity commitment and subcontractor/supplier usage for City of Fort Worth projects.
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BUS TRIP OVERNIGHT MEDICAL RELEASE FORM
PDF template
Medical and contact information form for student campus visit, including health insurance and emergency contact details.
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Play At Own Risk Waiver And Participant Consent To Treat Form
PDF template
Legal waiver and medical consent form for participants in a regional basketball championship tournament
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Physical Examination Form For Driver Applicant
PDF template
Medical evaluation form for assessing a driver's physical fitness, particularly for school bus drivers in Florida.
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LHT Risk Assessment Form
PDF template
A comprehensive form for assessing potential risks associated with a client, including behavioral, safety, and personal risk factors.
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Texas Immunization Registry (ImmTrac2) Minor Consent Form
PDF template
Consent form for registering a child's immunization records in the Texas Immunization Registry, allowing authorized entities to access vaccination information.
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WEST VIRGINIA WESLEYAN COLLEGE CAFETERIA PLAN MEDICAL CARE EXPENSE CLAIM FORM
PDF template
A form for submitting medical expense reimbursement claims under a cafeteria plan with detailed certification and documentation requirements.
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Release Form For Media Recording
PDF template
Legal consent form for the Cooley's Anemia Foundation to use photographs or recordings for thalassemia education purposes.
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ResidencyFellowship Non ERAS Common Application Form
PDF template
Comprehensive application form for medical residency and fellowship programs at the University of Connecticut School of Medicine
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Canine Assessment Form
PDF template
Comprehensive form for assessing a dog's lifestyle, home environment, and health status.
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PatientS Information Form
PDF template
Comprehensive medical form for collecting patient personal, contact, insurance, and healthcare provider information.
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Camp Dina Medical Form PhysicianS Page
PDF template
Medical form for physician documentation required for camp enrollment and health tracking.
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Camp Potlatch 2020 Medical Form
PDF template
A comprehensive medical form for parents/guardians to provide health information for children attending Camp Potlatch summer camp.
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Camp LMU Registration, Informed Consent, Student Medical Release Form
PDF template
Comprehensive registration form for Camp LMU, including personal information, emergency contacts, medical history, and photo release.
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Camp LMU Registration, Informed Consent, Student Medical Release Form
PDF template
A comprehensive registration form for Camp LMU that collects camper personal information, emergency contacts, medical details, and photo release consent.
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Youth Programs Medical Policy
PDF template
Medical policy and procedures for Nicholls State University youth program participants, detailing medical record and medication requirements.
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Medical Release Form 2023
PDF template
A comprehensive medical release and consent form for summer camp participants, including emergency treatment authorization and sign-out consent.
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Camp Potlatch 2022 Medical Form
PDF template
A comprehensive medical form for parents to provide health details about their child attending Camp Potlatch summer camp.
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Duquesne University Campus Residency Waiver Request
PDF template
A university form allowing students to request exemption from mandatory campus housing requirements.
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Safety ConcernsHazard Report Form
PDF template
A form for reporting and tracking safety hazards or concerns within a university campus environment.
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SAFETY CONCERNSHAZARD REPORT FORM
PDF template
A form for reporting safety concerns and potential hazards on campus by faculty, staff, or students.
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Canada Border Services Agency Consent Form
PDF template
A document for collecting consent and information related to border entry and customs procedures for individuals entering Canada.
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New Consultation Referral Form
PDF template
Medical referral form for new patient consultation at an oncology clinic, collecting patient diagnosis, referral details, and medical history.
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Cancer Claim Form
PDF template
Claim form for filing a cancer-related insurance claim with Aflac New York, requiring policyholder and patient details along with medical documentation.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient health history, contact information, and current medical status.
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CLAIM FORM AND INSTRUCTIONS
PDF template
A comprehensive insurance claim form for filing wellness exam benefits with instructions for submission and processing.
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CANINE EXPORT SUBMISSION FORM
PDF template
A veterinary diagnostic laboratory form for submitting canine export health testing and documentation for international animal transportation.
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Pet Health And Environment Questionnaire
PDF template
A detailed survey collecting information about pet ownership, pet travel, home environment, and pet health management.
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CANINE SUBMISSION FORM
PDF template
Legal form for submitting veterinary diagnostic specimens to Kansas State Veterinary Diagnostic Laboratory with billing and specimen information.
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Canterbury Street Pastors New Data Protection Regulation Consent Form
PDF template
A consent form for managing personal data and communication preferences for Canterbury Street Pastors supporters.
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CAOS Fellowship Application Form
PDF template
An application form for medical professionals seeking a fellowship in computer-assisted orthopaedic surgery with the International Society for Computer Assisted Orthopaedic Surgery.
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Standardized Application For Pathology Fellowships
PDF template
A comprehensive fellowship application form for pathology residency candidates covering personal, educational, and training details.
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MEDICAL HISTORY FORM
PDF template
A comprehensive form for patients to provide detailed medical information relevant to dental treatment and health assessment.
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Release Of Information Authorization Form
PDF template
A form authorizing Counseling and Psychological Services (CAPS) to release protected clinical information to designated persons or agencies.
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Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training across various subspecialties.
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Standardized Application For Pathology Fellowships
PDF template
Official application form for pathology fellowship candidates, covering personal information, education, and fellowship specialization preferences.
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Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized fellowship training in various pathology subspecialties.
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Capital Access Program (CAP) Notice And Waiver Form
PDF template
A formal document outlining borrower acknowledgment and waiver for participation in the Capital Access Program loan enrollment process.
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FMLA InformationRequest Packet
PDF template
Comprehensive packet of forms and instructions for employees requesting Family and Medical Leave Act (FMLA) leave through Carbon County HR.
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Vaccine Administration Consent Form
PDF template
A comprehensive form for documenting patient consent and medical eligibility for various vaccinations.
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Youth Sports League Roster Waiver
PDF template
A comprehensive form for youth sports team registration, including player and guardian contact information and liability release.
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Care Coordination Referral Form
PDF template
A form for requesting care coordination assistance for members with various health and support needs
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Caregiver Consent Act Affidavit
PDF template
An official form allowing non-guardian caregivers to consent to medical treatment for minors under specific circumstances in West Virginia.
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CAREGIVER CONTACT FORM
PDF template
A form for patients to provide details about a designated caregiver who can be contacted regarding their medical care and treatment.
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Caregiver Medical History Form
PDF template
A medical history form for caregivers to provide health background information for TNT staff review
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CaregiverS Authorization Affidavit
PDF template
A legal document authorizing a caregiver to enroll a minor in school, access medical care, and educational records
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Pre Authorisation Form Care
PDF template
A detailed medical insurance form for patients seeking cashless hospitalization, capturing personal, medical, and insurance details.
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Care Management Referral Form
PDF template
A referral form for recommending patients with complex medical or behavioral health conditions to care management programs.
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Mail Service Order Form
PDF template
A form for ordering prescriptions through mail service with health history and participant information collection.
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Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims with detailed patient and insurance information requirements.
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Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims to an insurance provider or healthcare plan.
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Caries Risk Assessment Form (0 5)
PDF template
A comprehensive form to evaluate a child's risk of tooth decay using criteria developed by the American Dental Association.
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CASE EVALUATION FORM
PDF template
A comprehensive medical assessment form for evaluating patient seating needs and physical condition using a BRODA chair.
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Consent Form For Case Reports
PDF template
A consent form for patients to authorize publication of medical information in journals or theses while maintaining patient anonymity.
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Casewatch Millennium Client Consent Form
PDF template
Consent form for registering and receiving HIV prevention services in Los Angeles County, authorizing information sharing for program management and reporting.
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CASL Medical Release Form
PDF template
A comprehensive medical release and liability waiver form for soccer players, allowing medical treatment and releasing organizations from liability.
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Medical History Form
PDF template
A comprehensive form for collecting medical information about a student's health conditions, medications, allergies, and parental consent for over-the-counter medication.
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Casualty Assessment Form
PDF template
Comprehensive medical assessment form for documenting patient condition, injuries, and treatment details.
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Risk Assessment Policy And Procedures
PDF template
A comprehensive policy for managing and conducting risk assessments within the Community Academies Trust, outlining processes, types of risk assessment, and regulatory compliance.
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Catastrophic Sick Leave Request Form
PDF template
A form for employees to request catastrophic sick leave due to extended illness or injury as defined by Alabama state law.
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Animal Patient Medical Record
PDF template
Comprehensive medical intake form for documenting a veterinary patient's health status and physical examination details.
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Patient Medical Information Form
PDF template
Comprehensive medical intake and tracking form for patient demographics, facility details, and medical specimen information.
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MONTREAT COLLEGE ATHLETIC DEPARTMENT SPORT PREPARTICIPATION EXAMINATION FORM
PDF template
A comprehensive medical screening form for college athletes to assess health conditions and potential risks before sports participation.
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WAIVER FORM
PDF template
A legal form allowing corporate officers, directors, general partners, and LLC managing members to opt out of workers' compensation insurance coverage in California.
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Criminal Background Check Consent And Waiver
PDF template
Consent form for UMass Chan Medical School students to undergo criminal background checks for clinical rotations.
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Juvenile Criminal Background Check Consent Form
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Form granting consent for a criminal background check for employment purposes at the University of Delaware
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Consent Guidance And Sample ParentGuardian Consent Form
PDF template
A consent document providing guidance and template language for survey consent procedures for teachers and students.
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Program Health And Waiver Form
PDF template
A comprehensive health and emergency contact form for program participants to provide medical information and consent for field station activities.
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CCCC Medical Sonography Program Volunteer Informed Consent
PDF template
Consent form for volunteer scan models participating in medical sonography student training at Central Carolina Community College.
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Student Activity Travel General Release And Waiver Of Liability
PDF template
Legal document releasing Calhoun Community College from liability during student activity travel events.
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Consent Form
PDF template
Consent document for parents/guardians regarding child observations, photography, and information sharing at a university lab school.
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CONSENT OF CHILD TO A PUBLIC AGENCY ADOPTION OR PRIVATE AGENCY ADOPTION (FORM 9 102.5)
PDF template
Legal form documenting a child's voluntary consent to being adopted by a specific party, with associated rights and understanding.
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Social Media Release Form
PDF template
A consent form allowing the Association for Creatine Deficiencies to use an individual's photograph and quote for awareness campaigns.
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Emergency InformationUpdate Form
PDF template
A comprehensive form for collecting child's emergency contact, medical, and parental information for YMCA child care programs
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Liability Waiver And Release Form (Minor Child)
PDF template
A legal document releasing the Chesterfield County Fair from liability for minor children participating in volunteer activities at the fairgrounds.
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New Patient Intake Patient Medical History
PDF template
Comprehensive medical intake form for new patients collecting detailed personal and health information.
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Pediatric Care Management Referral Form
PDF template
A comprehensive referral form for children aged 0-20 years to access care management and coordination services.
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Volunteer Form
PDF template
A comprehensive form for individuals interested in volunteering, collecting personal information and including liability waivers and consent agreements.
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California Consumer Privacy Act Parental Consent Form
PDF template
A form for parents or legal guardians to provide consent for the sale or access of a minor's personal information under California privacy regulations.
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Terra State Community College School Consent Form
PDF template
A form for high school students applying to take college courses through the College Credit Plus program, requiring high school counselor and parental consent.
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MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal information, medical history, lifestyle details, and emergency contacts.
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Cottonwood Crossing Summer Institute Health Information Form
PDF template
A comprehensive medical form for student participation in summer institute activities, collecting health insurance, medical history, and emergency treatment authorization.
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Personal Vehicle Travel Liability And Insurance Form
PDF template
A liability release form for students using personal vehicles for university-sponsored off-campus activities
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Safety Committee Policy
PDF template
Policy establishing the formation, membership, and purpose of a safety committee for the Deschutes County Adult Jail to promote workplace safety and health.
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HAZARD REPORT FORM
PDF template
A comprehensive form for reporting potential workplace hazards and assessing risk levels in an organizational setting.
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CDC 50.42A Adult HIV Confidential Case Report
PDF template
Comprehensive medical reporting form for documenting HIV cases for patients over 13 years of age, used by health departments and CDC for surveillance purposes.
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CDCI Media Release Form
PDF template
A consent form allowing the Center on Disability and Community Inclusion to use an individual's media and quotes for educational purposes.
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Authorization For Release Of Information
PDF template
A form authorizing the Federal Motor Carrier Safety Administration to disclose medical records related to a commercial vehicle operator's medical exemption application.
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Commonwealth Of Dominica Physical Examination Report
PDF template
A comprehensive medical screening form for seafarers detailing personal and medical history
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Pre Employment Medical Form
PDF template
Comprehensive medical assessment form for pre-employment screening including medical history, vital signs, and tuberculosis screening.
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COVID 19 VACCINE CONSENT FORM
PDF template
Comprehensive consent form for receiving COVID-19 vaccination, collecting patient medical information and screening for potential vaccine contraindications.
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CDPHP Co Pay Reimbursement Form
PDF template
Form for employees to submit medical co-pay expenses for reimbursement through Hudson Valley Community College's healthcare program.
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Celiac Disease Diagnostic Testing Requisition Form
PDF template
Medical form for ordering celiac disease diagnostic tests, including patient and prescriber information and insurance details.
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PATIENT REGISTRATION MEDICAL HISTORY FORM
PDF template
Comprehensive medical registration form for patient intake, collecting personal, contact, and insurance information for medical services.
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VCU RCDI G CENC External Concussion Diagnostic Interview
PDF template
A medical interview form for documenting potential concussive events and detailed injury information
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Patient Referral Form
PDF template
A comprehensive healthcare referral document for patient intake, medical assessment, and service selection.
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Application For Waiver Of Probate Bond
PDF template
Legal document for estate representatives to request waiver of probate bond and provide estate details
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MEDICAL RELEASE FORM
PDF template
A legal form allowing medical treatment for a minor in the absence of a parent or guardian, including consent for medical procedures and documentation of medical history.
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Emergency Exam Cancellation Form
PDF template
Form for clinical research professionals to request fee waiver for exam cancellations due to emergencies or extenuating circumstances.
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Certification Of Need And Waiver Of Liability (Prescription Delivery)
PDF template
A form for patients without transportation to receive prescription medication delivery, including liability release and risk assumption.
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MEDICAL FORM
PDF template
Confidential medical history form for collecting patient personal and health information for medical examination purposes.
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Media Release Form
PDF template
A legal document authorizing the University of Utah College of Fine Arts to use photographs, recordings, and artwork for various promotional purposes.
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Daily Waiver Form
PDF template
Comprehensive waiver form for participants of Wilmette Park District Fitness Center, covering injury risks, medical treatment, and photography consent.
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Consent Form Checklist For Reliance On External IRBs
PDF template
Guidance for UCLA investigators creating site-specific consent forms when relying on external Institutional Review Board (IRB) approval.
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Incident Report Form
PDF template
A comprehensive form for documenting injuries and incidents at CrossFit facilities, used for risk management and insurance purposes.
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Candia Farmers Market Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing Candia Farmers Market from liability for potential accidents or injuries during market participation.
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Consent For Release Of Information
PDF template
A form allowing consent for releasing personal information by the Illinois Department of Children and Family Services.
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Amendment Of Insured Contract Definition
PDF template
Insurance policy endorsement modifying the definition of 'insured contract' in a commercial general liability coverage part.
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OCCUPATIONAL MEDICAL HISTORY AND EXAMINATION FORM
PDF template
A comprehensive medical examination form for U.S. Coast Guard employees covering personal and occupational health information and potential workplace exposures.
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International Group Travel Release
PDF template
Legal release document for participants in international group travel programs, outlining risks and liability waivers for Claremont Graduate University programs.
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MEDICAL INFORMATION AND RELEASE FORM
PDF template
A comprehensive medical form for participants in Hartwick College Challenge Programs, collecting health information and liability acknowledgment.
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CHAMP Assessment Medical History Form
PDF template
Comprehensive medical history form for fitness assessment program, collecting health and exercise background information from participants.
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2020 States 4 H OB Medical Form (Non Japan)
PDF template
Medical evaluation form for chaperones participating in a cross-cultural exchange program, assessing health status and medical conditions.
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Release Of Liability, Acknowledgement Of Risk And Acceptance Of Responsibility
PDF template
Legal document waiving liability for risks associated with participating in a Community Corrections Chase event.
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Tarrant County College District Institutional Review Board Informed Consent Form Checklist
PDF template
A comprehensive checklist for reviewing research study informed consent documents to ensure proper ethical and procedural standards.
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CHEMICAL HAZARD RISK ASSESSMENT FORM
PDF template
A comprehensive form for identifying and documenting potential chemical research hazards and safety control measures.
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IMPACT STORY PHOTO RELEASE AND CONSENT AGREEMENT FORM
PDF template
A legal agreement allowing the American Kennel Club Canine Health Foundation to use specified photographs for organizational purposes.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient personal, contact, and medical information for a medical practice.
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Health Care Provider Exam Form
PDF template
A comprehensive medical examination form for tracking patient vaccinations, health status, and provider details.
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Child Care General Health Examination Form
PDF template
A health examination form for children entering child care programs, documenting their general health status and medical information.
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Child Care General Health Examination Form
PDF template
A medical form documenting a child's health status and conditions for child care program enrollment.
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Child Care General Health Examination Form
PDF template
A medical form documenting a child's health status and conditions for child care enrollment.
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Free Screening Consent Form Childcare
PDF template
A consent form for parents to authorize developmental screening for children at a childcare facility, allowing parents to indicate specific developmental concerns.
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Child Comprehensive Medical Release Permission Form
PDF template
Medical release and permission form for children participating in parish or diocesan activities, capturing health information, emergency contacts, and medical history.
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Application For Child Life Internship
PDF template
Application guidelines and requirements for internship positions at Children's Hospitals and Clinics of Minnesota's Child Life Department.
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Child Patient Intake Form
PDF template
Comprehensive intake form for children with cancer, collecting patient and family information for Rock Cancer Care services.
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Delaware Child Protection Registry Consent Form
PDF template
Form for authorizing release of substantiated child abuse/neglect cases from the Delaware Child Protection Registry.
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Child Registration Form
PDF template
A comprehensive form for registering a child, collecting personal and insurance information for medical or childcare purposes.
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MEDICAL And LIABILITIES RELEASE FORM
PDF template
A comprehensive form for medical information and liability release for children participating in church activities and programs.
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MEDICAL HISTORY CHILD
PDF template
Comprehensive medical history questionnaire for collecting pediatric health information and previous medical conditions.
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Calvary Baptist Church ChildrenS Ministry Participant Permission Medical Release
PDF template
A comprehensive permission and medical release form for children participating in Calvary Baptist Church ministry activities during 2024.
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Child Travel Consent Form
PDF template
A legal document granting permission for a minor to travel internationally with one parent or guardian, addressing potential child abduction concerns.
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Child Travelling Alone Legal Form
PDF template
Legal form for parents/guardians authorizing solo travel for 16-17 year old participants in CISV international programs with medical consent and release provisions.
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Health Information Form
PDF template
Confidential health information form for participants in an international research program between Alabama A&M University and Nanjing Forestry University.
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STUDENT HEALTH FORM
PDF template
Comprehensive health form for students to provide medical information and health status to an educational institution
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Department Of RadiologyImaging Services Pre Scheduling Evaluation Form
PDF template
Medical form used by physicians to request and evaluate imaging services, including patient details and medical history for CT or MRI scans.
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CLIENT REQUISITION FORM
PDF template
A comprehensive medical test requisition form for various health diagnostics including inflammation, lipids, metabolic, and other specialized tests.
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Chronic Illness Benefit Application Form
PDF template
An application form for patients seeking chronic illness benefits through the Glencore Medical Scheme, detailing submission requirements and contact information.
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Chronic Medical Condition Treatment Compliance Form
PDF template
Form documenting a patient's ongoing medical treatment and compliance with care standards for at least 6 months
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CIEF Membership Form 2019 2020
PDF template
Membership form for competing and non-competing members of a sports or equestrian organization
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Cigna Claim Form (Rev. 72015)
PDF template
A comprehensive form for submitting healthcare service reimbursement claims with patient, provider, and payment information.
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Medical Claim Form
PDF template
Form for submitting medical claims for fellows, trainees, and patients seeking international health insurance reimbursement.
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TEST REQUISITION FORM
PDF template
A laboratory test request form for clinical immunodiagnostic testing with patient and specimen information collection fields.
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Notice Of Lawsuit And Request For Waiver Of Service Of Summons
PDF template
A legal document requesting waiver of formal service of summons in a civil legal proceeding to reduce service costs.
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Waiver Of Service Of Summons
PDF template
Legal document allowing a defendant to waive formal service of court summons to reduce legal processing costs.
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2021 CIVME Research Grant Program Grant Application Instructions
PDF template
Instructions and guidelines for applying to the Council on International Veterinary Medical Education research grant program.
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Military Medical Intake And Deployment Assessment Form
PDF template
Comprehensive medical assessment form for active duty military personnel covering health status, deployment readiness, and substance abuse screening.
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Waiver Service Request Form
PDF template
Form for requesting driver assessment and training services for rehabilitation clients with potential adaptive driving needs.
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MEDICAL EXPENSE CLAIM
PDF template
Form for filing medical expense claims with Blue Cross and Blue Shield of Alabama when a healthcare provider does not file a claim directly.
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CIEE Claim Form
PDF template
A comprehensive medical claim form for student health insurance reimbursement and documentation of medical conditions or treatments.
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Dental Insurance Claim Form
PDF template
Insurance claim form for submitting dental treatment and patient information for reimbursement or coverage verification.
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Student Insurance Claim Form
PDF template
Insurance claim form for students to report medical examinations, illnesses, prescriptions, or injuries for insurance coverage.
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Claim Form Finder And User Guide
PDF template
Comprehensive guide to help healthcare providers select the appropriate claim form for various submission scenarios and corrections.
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Claim Form Finder
PDF template
Comprehensive guide for healthcare providers detailing claim modification forms and processes for Neighborhood Health Plan of Rhode Island.
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Details Of Hospital Claim Form Part B
PDF template
A comprehensive medical claim form for documenting patient hospital admission, treatment, and insurance claim details.
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Member Reimbursement Form For Medical Claims
PDF template
A form for patients to submit medical claims for reimbursement, detailing patient, subscriber, and provider information.
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Claims Reimbursement Form
PDF template
A comprehensive form for submitting medical claims for reimbursement, used by patients or healthcare providers to request payment for medical services.
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Claims Reporting Reference Guide
PDF template
A comprehensive guide for reporting insurance claims across multiple coverage types and managing workplace incidents
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RELEASE AND CONSENT FORM
PDF template
A consent form allowing Clarke Schools to use a student's name, words, art, and images for promotional and educational materials.
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Special Olympics Volunteer Consent Form
PDF template
Consent form for volunteers to participate in Special Olympics programs, including personal information usage and privacy agreements.
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Volunteer Application Form Class A Minor (Under 18)
PDF template
Application form for minors under 18 years old interested in volunteering with Special Olympics, including consent and privacy agreements.
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Student Class Evaluation
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An evaluation form for students to provide feedback on educational programs and instructors in emergency medical services.
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Class Waiver Form
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A form to request waiving a certification class requirement in the MSBO Voluntary Certification Program based on existing credentials or experience.
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General Media Release Form
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A comprehensive form for media use authorization and liability release for The Cutting Edge Classroom's activities.
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PacificSource Enrollment Application
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A comprehensive group health insurance enrollment form for employees and their dependents to select medical and dental coverage.
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Patient Information Form
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Comprehensive patient intake form collecting personal, contact, medical, and insurance information for dermatology services.
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NCAA Drug Testing Consent Form
PDF template
Legal document requiring student-athletes to consent to drug testing as part of NCAA athletic participation regulations.
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Cancer Services Client Intake Form
PDF template
Confidential intake form for cancer patients seeking free services in Erie, Huron, and Ottawa counties in Ohio.
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Cancer Services Client Intake Form
PDF template
Comprehensive intake form for cancer patients seeking free support services, collecting personal, medical, and financial information.
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Account Holder Authorization And Consent Form
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A consent form allowing the Department of Community Services and Development to share utility account information for energy assistance program evaluation.
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ClientParental Consent Form
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Consent form for clients receiving counseling services from graduate student counselors at Texas A&M University-Commerce, including recording and supervision provisions.
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ParentalStudent Consent Form School Setting
PDF template
A consent form for parents to authorize counseling services for their child by a graduate counseling trainee at Texas A&M University-Commerce.
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ClientSite Risk Assessment (Part I)
PDF template
A comprehensive form for evaluating potential safety and risk factors before and during client site visits
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Update Client Contact Form
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A form for updating client contact information and acknowledging financial responsibility at a veterinary clinic
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Update Client Contact Form
PDF template
A form for veterinary clients to update contact information, communication preferences, and provide consent for financial and photographic terms.
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CLIMBucknell MEDICAL FORM
PDF template
Medical history and emergency contact form for participants in a university climbing/ropes course activity
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Accident Waiver And Release Of Liability
PDF template
A comprehensive legal document releasing event organizers from liability for potential injuries or damages during an athletic event.
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CLINICAL BOOKING FORM
PDF template
A form for scheduling telehealth consultations and televisitation events for healthcare professionals.
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Behavioral Health Discharge Clinical Form
PDF template
A clinical form for documenting patient discharge details from behavioral health treatment, including care level, residence, and follow-up appointments.
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Clinical Incident Report Form 4.3
PDF template
A form documenting details of a clinical incident, including injury, location, witnesses, and actions taken.
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Nephrology Laboratory Test Requisition
PDF template
A clinical form for requesting laboratory tests related to complement system and nephrology research at Cincinnati Children's Hospital.
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Application For Admission Into The Combined Master Of Veterinary Studies Master Of Veterinary Clini
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Application form for domestic students seeking admission to specialized veterinary clinical residency programs at the University of Sydney.
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HARKNESS CENTER FOR DANCE INJURIES PATIENT MEDICAL HISTORY FORM
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Comprehensive medical history form specifically designed for documenting dance-related injuries across multiple body regions.
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PATIENT DISCHARGE PROTOCOL
PDF template
Comprehensive protocol for veterinary patient discharge, covering communication with client, medical record review, medication instructions, and post-surgical care guidance.
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Clubs Emergency Contact Information
PDF template
School emergency contact and medical information form for recording student and parent contact details and health information.
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Notice Of Field Trip And Waiver Of Liability
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A legal document for students participating in a voluntary field trip, requiring a signed waiver of liability by the participant.
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Data Protection Consent Form
PDF template
Consent form for clubs and societies to allow personal data usage on Hethersett Parish Council website in compliance with GDPR regulations.
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Club Sports Informed Consent Form
PDF template
A legal consent and liability release form for students participating in club sports at Connecticut College, acknowledging risks and insurance responsibilities.
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ClubTeam Roster Authorization Form
PDF template
A form allowing students to authorize release of their information for club or team rosters, in compliance with FERPA guidelines.
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Medical History Form
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Comprehensive medical history form collecting patient's personal health details, family medical history, and lifestyle information.
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Population Assessment Of Tobacco And Health (PATH) Study Parent Consent And Permission For Youth Int
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A consent form for parents to allow their children aged 12-17 to participate in a national tobacco and health research study.
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Request For Waiver Form
PDF template
Official form for medical assistants to request a waiver for certification exam eligibility due to criminal history or professional license issues.
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Health And Emergency Contact Form
PDF template
A comprehensive form for collecting student medical history, emergency contact details, and healthcare consent at Central Maine Community College.
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PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient demographic, family medical history, and personal health information.
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Form CMS 10106 Authorization To Disclose Personal Health Information Release Form
PDF template
A form allowing Medicare beneficiaries to authorize the sharing of their personal health information with designated individuals.
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Centers For Medicare And Medicaid Services EDI Registration Form
PDF template
A registration form for healthcare providers to establish electronic data interchange (EDI) capabilities with the Centers for Medicare and Medicaid Services.
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Centers For Medicare And Medicaid Services EDI Registration Form
PDF template
Form for healthcare providers to register for Electronic Data Interchange (EDI) transactions with Centers for Medicare and Medicaid Services.
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Form CMS 116 (0324)
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Clinical Laboratory Improvement Amendments (CLIA) certification application for health laboratories seeking federal certification.
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HEALTH INSURANCE CLAIM FORM
PDF template
Standard medical insurance form for submitting healthcare claims and patient information for reimbursement purposes.
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Health Insurance Claim Form
PDF template
Official form for submitting medical insurance claims and capturing patient and insured party information.
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CMS Model Consent Form For Marketplace Agents And Brokers
PDF template
A model consent form for documenting consumer permission for health insurance agents or brokers to assist with marketplace coverage enrollment.
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CMS Model Consent Form For Marketplace Agents And Brokers
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A model consent form for documenting consumer permission for health insurance agents or brokers to assist with Marketplace coverage enrollment.
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CMSP 215 Supplemental Application
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Application form for individuals seeking medical services coverage through the County Medical Services Program with rights and responsibilities outlined.
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CN 28 Application For Waiver
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Instructions and form for requesting a waiver from New Jersey Department of Health licensing standards for healthcare facilities.
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Adult Medical History Form
PDF template
Comprehensive medical history form for collecting patient health information, symptoms, and medical conditions.
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Infant Medical History Form
PDF template
Comprehensive medical history form for pediatric patients covering medical tests, therapies, medications, developmental milestones, and birth history.
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CNHS Insurance Requirements Proof Of Health Insurance Form
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Form for documenting student health insurance coverage for clinical and practicum rotations in the College of Nursing & Health Sciences.
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CNS User Fee Waiver Form
PDF template
A form to request waiver of user fees when a CNS facility or tool malfunctions during a scheduled reservation.
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Conservation Northwest Field Volunteer Waiver Form
PDF template
A legal waiver form for volunteers participating in wildlife monitoring and conservation field work with Conservation Northwest.
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Conservation Northwest Field Volunteer Waiver Form
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A legal waiver form for volunteers participating in wildlife monitoring and outdoor conservation projects with Conservation Northwest.
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SPORT CLUB COACHES MEMBERSHIP FORM
PDF template
Form for coaches to apply for membership and participation in university recreational sports programs with liability waiver and approval process.
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COVID 19 Code Of Conduct And Waiver Form Addendum
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Guidelines and requirements for participant forms and safety protocols for Special Olympics Washington during the Summer Season
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Medical Release Form
PDF template
A medical consent and release form for student participation in activities, allowing emergency medical treatment with parental authorization.
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Community Of Gardens Teacher Parental Consent Form
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A consent form allowing children to participate in a digital archive project documenting garden heritage through student submissions.
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Referral Form
PDF template
A form for healthcare providers to request patient referrals and provide medical background information.
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College Sponsored Related Medical And Travel Form
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A medical and travel authorization form for students participating in college-sponsored activities with COVID-19 compliance and liability waiver provisions.
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Camp Medical Form, College Tennis Exposure Camp
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Medical form for participants of a college tennis exposure camp, capturing health history and emergency contact information.
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COLOGUARD ORDER REQUISITION FORM
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Medical order form for Cologuard, a stool-based DNA test used for colorectal cancer screening
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COLOGUARD ORDER REQUISITION FORM
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Medical order form for Cologuard, a stool-based DNA test for colorectal cancer screening
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Insurance Claim Processing Instructions
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Instructions for submitting an insurance claim, including required documentation and processing details for Colonial Life & Accident Insurance Company.
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New Patient Intake Form
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Comprehensive medical intake form for new patients to collect personal, contact, and health information for medical providers.
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AFI PRE AUTHORIZATION FORM FOR HOSPITALIZATION FROM PANEL NON PANEL HOSPITALS
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A form for obtaining pre-authorization for hospitalization from panel and non-panel hospitals for insurance coverage.
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ImMTrax Consent Forms Adults And Children
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Consent form for collecting and storing immunization records for children and adults in a public health information system.
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Information Disclosure Consent Form For UN COVID 19 Medical Evacuation (MEDEVAC) Services
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Consent form for medical information disclosure and liability release for UN COVID-19 medical evacuation services.
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NEW PATIENT REGISTRATION FORM
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Comprehensive form for new patient medical registration, including personal information, medical history, insurance details, and a physician-patient arbitration agreement.
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PRDL Commercial Poultry Submission Form
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A comprehensive form for submitting poultry specimens for laboratory diagnostic testing and analysis.
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Pre Professional Evaluation Waiver Form
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A form allowing students to choose whether to waive or retain access rights to their recommendation letters for professional school applications.
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NAIC Enterprise Risk Report (Form F) Implementation Guide
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A guide for preparing and reviewing annual enterprise risk reports for insurance holding company systems as part of NAIC accreditation requirements.
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Common Child And Adolescent Psychiatry Application
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An application form and procedure guide for medical professionals seeking child and adolescent psychiatry residency programs.
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ResidencyFellowship Non ERAS Common Application Form
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Comprehensive application form for medical residency and fellowship candidates seeking placement at the University of Connecticut School of Medicine.
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Standardized Application For Pathology Fellowships
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A comprehensive application form for medical professionals seeking pathology fellowship training in various subspecialties.
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AUTHORIZATION TO USE AND EXCHANGE INFORMATION
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A multi-agency authorization form allowing specified information sharing among various social service, health, and government agencies in Virginia.
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Communicable Disease Report For Healthcare Providers
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A comprehensive medical reporting form for healthcare providers to document communicable disease cases in Arizona.
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Marquette University ComMUnity Physical Therapy Clinic Referral Form
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A referral form for patients seeking physical therapy services at Marquette University's Community Physical Therapy Clinic.
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Community Membership Form
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A medical history and liability waiver form for campus recreation membership at Lees-McRae College, requiring personal and medical information along with a hold harmless agreement.
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Health Care Provider Complaint Form
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Official form for filing a complaint against a healthcare provider in Florida with detailed information requirements for investigation.
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Complaint Report Form
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Form for reporting patient complaints and potential protected health information disclosure at UW-Milwaukee
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The Wellness Plan ComplaintResolution Form
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A form for documenting patient complaints, concerns, and their resolution within a medical center's wellness plan.
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STEPSFORMS TO SEE DR. SENIOR
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Detailed guidelines for students seeking to schedule and attend a psychiatric appointment with Dr. Senior at Landmark College.
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Emergency Contact Form
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A form for students to provide emergency contact details and medical authorization for University of Detroit Mercy.
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Comprehensive Pain Assessment Form
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A detailed form for evaluating and documenting a patient's pain characteristics, intensity, and management goals.
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Media Release Form
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A consent form allowing Central Ohio Music Therapy to use participant interviews, quotes, photographs, and media for non-profit purposes.
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Authorization For Examination Or Treatment
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A medical authorization form for workplace-related medical examinations, testing, and treatment with comprehensive patient and service details.
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Concussion Incident Form
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A form for documenting and reporting concussion-related incidents in sports, specifically for Ringette Canada.
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Concussion Waiver Form
PDF template
A waiver form requiring student athletes to acknowledge and report concussion symptoms to medical staff.
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Concussion Waiver Form
PDF template
A waiver form for student athletes acknowledging their responsibility to report concussion symptoms and potential injuries.
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Concussion Waiver Form
PDF template
A waiver form requiring student athletes to acknowledge their responsibility in reporting concussion symptoms and understanding concussion risks.
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Montana Newborn Screening Program Condition Nomination Form
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A form used by healthcare professionals to nominate new medical conditions for inclusion in Montana's newborn screening panel.
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Confidential Medical History Form
PDF template
Comprehensive medical symptoms and conditions checklist for patient intake, covering multiple body systems and health concerns.
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Acknowledgement Of Agreement Form
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A registration and consent form for youth participation in the All Saints Confirmation Program, requiring parent or guardian consent and submission of specific documentation.
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Consent For Participation In Citywide Immunization Registry (CIR) For Individuals 19 Years Of Age An
PDF template
A consent form for individuals 19 and older to participate in the New York Citywide Immunization Registry, allowing health providers to access and record immunization records.
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Informed Consent Form For Research Involving Human Subjects
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An informed consent document for a research study exploring perceptions of charismatic speech conducted by Claremont McKenna College.
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DATA PROTECTION CONSENT FORM
PDF template
A consent form for individuals to authorize the church's use of personal contact information for communication and directory purposes.
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Informed Consent Agreement
PDF template
Consent document for a research project documenting African American community life in Albemarle County, Virginia from 1870-1940 through community interviews and archival collection.
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CONSENT INSURANCE FORM
PDF template
A comprehensive form for collecting medical insurance and consent information for a cadet or applicant, including parent/guardian details and insurance policy information.
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Application For A Background Check Consent Form
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A consent form allowing Grand Ducal Police to conduct background checks and request criminal record information for an applicant.
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Internet Based Survey Consent Form
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Guidelines for creating ethical and compliant consent forms for internet-based research surveys, focusing on participant rights and data protection.
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Participant Consent Form
PDF template
A consent form for participants of a workshop, explaining survey data collection and potential Medicare study participation.
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Filling In Submitting A Consent Form 101
PDF template
A detailed guide for creating and completing consent forms in RSS, explaining form configuration and submission process.
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BACKGROUND CHECK CONSENT FORM
PDF template
Consent form authorizing the U.S. Air Force to conduct background checks for installation access eligibility.
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WYLIE ISD STUDENT RANDOM DRUG TESTING CONSENT FORM
PDF template
Consent form for random drug testing of students participating in extracurricular activities or parking on school district property.
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Name Based Criminal History Record Information (CHRI) ConsentInquiry Form
PDF template
A form for authorizing criminal history record checks for various purposes including employment and volunteer positions in Cherokee County.
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Consent For The Release Of Police Information And Disclosure Of Personal Information
PDF template
A comprehensive form allowing consent for multiple types of personal information searches, including criminal records, driver records, and background checks.
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Adult Consent Form
PDF template
A comprehensive medical consent form for adults, collecting personal information and health history details prior to medical treatment or vaccination.
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Consent Form Arabic
PDF template
A form for obtaining consent to share personal information about an individual with another party.
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Name Based Criminal History Record Information ConsentInquiry Form
PDF template
A consent form authorizing a criminal history background check for various employment and service purposes in Georgia.
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Child Consent Form
PDF template
A comprehensive health screening form for children to assess medical history and vaccination readiness.
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Consent Form Guide
PDF template
Guide for creating informed consent forms for research studies, providing detailed instructions for researchers on preparing consent documentation.
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Human Subject Informed Consent
PDF template
Research project consent form for parents/guardians regarding a study on lexical-phonological profiling of speech sound normalization by the Department of Communication Sciences and Disorders at Northern Arizona University.
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PHOTOVIDEO CONSENT FORM
PDF template
A legal document granting McGill University permission to use photographs or video images of a participant for university purposes.
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Community Partner Assistance Consent Form
PDF template
Consent form authorizing a community partner organization to assist with health coverage application and enrollment process.
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ATTACHMENT ADULT CONSENT FORM (EXAMPLE)
PDF template
Research consent form for a study exploring participants' experiences related to child abuse and religious contexts.
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Family Educational Rights And Privacy Act (FERPA) Student Consent Form
PDF template
A form allowing students to authorize release of their educational records to specified parties, in compliance with federal privacy regulations.
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Consent Form For Research Participation
PDF template
A comprehensive guide and template for creating a consent form for research participation at Oakland City University.
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Informed Consent To Audiotape Or Videotape Counseling Interviews
PDF template
A consent form allowing audio or video recording of counseling sessions for training and supervision purposes.
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Consent Form For Travelling Abroad With A Minor
PDF template
Official form documenting parental/guardian consent for a minor to travel internationally, including travel and identification details.
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SUNY ONEONTA INSTITUTIONAL REVIEW BOARD CONSENT FORM HELP
PDF template
A comprehensive guide and checklist for researchers developing consent forms for research studies at SUNY Oneonta.
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Consent Form ImPACT Baseline Concussion Testing
PDF template
A consent form for participating in baseline concussion testing for student-athletes in Montgomery County Public Schools.
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Consent Form Instructions And Samples
PDF template
Comprehensive guide for creating ethical research consent forms, outlining required elements and IRB considerations for participant informed consent.
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CONSENT FORM Adults
PDF template
Comprehensive instructions for creating clear and understandable consent forms for research studies involving human subjects.
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Options For The Consent Form Key Information Section
PDF template
Federal guidelines for presenting key information in human research consent forms, focusing on clarity and comprehension for prospective research subjects.
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Loanhead Miners Youth FC Parental Consent Form
PDF template
A comprehensive consent form for parents/guardians to authorize their child's participation in youth football club activities and provide medical and emergency information.
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Utah State Board Of Education ParentGuardian Consent Form Maturation Instruction
PDF template
A parental consent form for students participating in puberty and reproductive health education classes in Utah schools.
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Consent Form To Share Student Information With State Transition Agencies
PDF template
Optional consent form allowing schools to share student information with state transition agencies to support disability services and post-school employment planning.
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CIAC Background Check Consent Form
PDF template
Consent form for high school sports officials in Connecticut requiring a criminal background check for officiating clearance.
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Sample Consent Forms Individual Interviews
PDF template
A consent form for a research study exploring services and barriers for crime victims with disabilities through individual interviews.
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Consent Form Standards And Language For Non Medical Research
PDF template
Comprehensive guidance for creating consent forms for research involving Virginia Department of Social Services clients, focusing on clear formatting and participant understanding.
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Vermont Secondary College Student ConsentAgreement Form
PDF template
Multi-section consent form covering local excursions, image usage, technology use, and digital platform access for students at Vermont Secondary College.
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Land Development Division Consent Form
PDF template
A consent form for property owners to authorize an agent to submit land development applications in Palm Beach County.
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Consent To Disclose Tax Return Information
PDF template
A consent form allowing tax preparation services to report aggregate program statistics while protecting individual taxpayer privacy.
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USE OF CLINICAL MATERIALS CONSENT FORM
PDF template
A consent form for CPE students allowing the use of their clinical materials and observation media for certification, peer review, and research purposes.
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Volunteer Criminal Background Check Consent Form
PDF template
Authorization form allowing Fulton County School District to conduct criminal history background checks for volunteer applicants.
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Perry County Drug Testing Consent Form
PDF template
A consent form for job applicants to agree to a pre-employment drug screening process by Perry County.
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Consent For Publication Form
PDF template
A form granting permission for personal information or medical details to be published in a journal or article while acknowledging potential public exposure.
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Consent For Sterilization
PDF template
A federal form documenting informed consent for permanent sterilization procedure, explaining patient rights and understanding of the irreversible nature of the operation.
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Consent For Telebehavioral Health
PDF template
A consent document outlining the terms, requirements, and privacy standards for receiving telebehavioral health services via teleconferencing platform.
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Data Protection Consent Guidance
PDF template
Comprehensive guidance on obtaining and managing valid consent for personal data processing under UK GDPR regulations.
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Minor Athlete General Consent Form
PDF template
A comprehensive consent form for parents/guardians to authorize various in-program activities and training sessions for minor athletes in USA Gymnastics.
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Consent Of Candidate Local Elections
PDF template
Official form for candidates to consent to ballot placement and specify name and party details for local elections in Vermont.
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Annual Consent For One On One Travel Between Adult Participant And Minor Athlete
PDF template
Policy governing one-on-one travel between adults with authority and minor athletes, including consent requirements and exceptions
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CONSENT TO EXAMINE AND AUDIT SPECIAL ACCOUNTS
PDF template
Form authorizing the Illinois Department of Financial and Professional Regulation to examine and audit special real estate accounts
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Consent Short Form Instructions
PDF template
Guidelines for obtaining informed consent from non-English speaking research participants using a short form and interpreter process.
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CONSENT FOR SURGERY OR SPECIAL DIAGNOSTIC Or THERAPEUTIC PROCEDURE(S)
PDF template
Medical consent document outlining patient agreement for surgical or diagnostic procedures, risks, and treatment details.
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Informed Consent Form For Identity Inclusive Computing Tenets Incorporation In K 16 CS
PDF template
Research study consent form for collecting data on identity-inclusive computing practices among K-16 educators with optional participation and confidentiality assurances.
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Consent To Electronic Delivery Of Forms 1099
PDF template
Form for providing consent to receive IRS Form 1099 electronically instead of by paper mail.
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Consent To Treat Form
PDF template
Parental consent form for chiropractic evaluation and treatment of a child, with specific limitations on diagnostic scope.
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Consent For Treatment
PDF template
Comprehensive patient consent document covering treatment, benefits assignment, privacy practices, and telemedicine consent for Kentucky Cardiology medical services.
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Authorization For Medical Treatment Of Child
PDF template
A form allowing school representatives to consent to medical treatment for a student when parents cannot be reached during an emergency.
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Providence Mountain Emergency Services Consent To Treat Form
PDF template
Medical release and emergency treatment authorization form for participants in Providence Mountain program from December to May.
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Consent To Treat Release Form
PDF template
A form authorizing Woodward School to secure medical treatment for a student in emergency situations when parents cannot be immediately contacted.
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ParentGuardian Authorization For Regular Extracurricular Travel And Consent To Emergency Treatment O
PDF template
A school district form authorizing student participation in extracurricular activities and providing emergency medical consent.
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Consent Form For Physical Therapy Services
PDF template
A document outlining patient expectations, treatment planning, and payment procedures for physical therapy services.
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USA Hockey National Championships Consent To TreatMedical History Form
PDF template
A comprehensive medical history and consent to treat form for USA Hockey participants, covering emergency contact, medical history, and insurance information.
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Authorization Informed Consent
PDF template
Consent form for behavioral health services covering patient authorization, medical record release, and payment agreements.
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CONSENT TO TREAT MINOR CHILDREN
PDF template
A legal form allowing parents or guardians to provide medical treatment consent for a minor child when the parent is not immediately available.
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USA Hockey National Championships Consent To TreatMedical History Form
PDF template
Medical consent and history form for USA Hockey participants, allowing medical treatment and collecting health information for emergency purposes.
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Consent To Treat Form
PDF template
A medical consent form for treatment at Apollo Sports Performance, detailing procedures, risks, and patient agreement.
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Consent To Treat Form For USA Climbing Team Athlete
PDF template
A consent form for athletes to receive physical therapy treatment at USA Climbing events with specified terms and conditions.
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Consent To Verbally Disclose Protected Health Information To Family Members And Friends
PDF template
A form allowing patients to designate specific individuals who can receive verbal medical or health plan information.
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Medical Release Form (For Students Under The Age Of 18)
PDF template
A consent form allowing medical treatment for students under 18 when parents/guardians cannot be immediately contacted.
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Consent To Volunteer Form
PDF template
A consent form for minors seeking to volunteer at Purdue University Fort Wayne, requiring parental/guardian approval and background registry checks.
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CONSENT, WAIVER, RELEASE AND INDEMNITY AGREEMENT
PDF template
A legal document outlining participant consent, risk assumption, and liability waiver for a university program or activity.
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Consent, Waiver, Release And Indemnity Agreement
PDF template
Legal document outlining participant consent, risk assumption, and liability waiver for international medical exchange programs.
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Drug Request Packet
PDF template
Comprehensive guidelines and form for obtaining drugs from the University of Minnesota Veterinary Medical Center Pharmacy, including requirements for drug requests and controlled substances.
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INDOT Permit Section Consent Form
PDF template
A consent form allowing an applicant to authorize a representative to submit documents for obtaining a right of way permit from the Indiana Department of Transportation.
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Pathology Consult Request Form
PDF template
A form for requesting pathology consultation and case review between medical institutions.
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Contact Information And Medical Form
PDF template
A comprehensive medical form collecting participant's personal information, emergency contacts, medical history, and health conditions for University of Maine at Presque Isle program participation.
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Contract Request Form (CRF)
PDF template
Form for healthcare providers to request a contract and credentialing with Molina Healthcare
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McLaren Flint Foundation Contribution Form
PDF template
Fundraising form for making charitable donations to McLaren Flint Foundation with multiple designated giving options.
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Annual Controlled Substance Inventory Form
PDF template
A form for tracking and documenting annual physical inventory of controlled substances as required by state and federal regulations.
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Liability Waiver Form
PDF template
A legal document releasing the University of Louisville from liability for participation in the Suzuki Studies Program and acknowledging program policies.
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Consent Form Collaborative On Line Research And Learning (CORAL)
PDF template
A consent form for a university research study investigating collaborative online learning effectiveness using questionnaires and communication tools.
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Consent Form Collaborative On Line Research And Learning (CORAL)
PDF template
A consent form for a university research study investigating collaborative online learning effectiveness using senior seminar and social psychology courses.
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Cornerstone Informed Consent Form
PDF template
Consent form for collecting and storing participant health information through Cornerstone system in Illinois
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City Of Socorro 2024 Cornhole League Registration
PDF template
Registration form for participating in the City of Socorro's 2024 Cornhole League, including league rules and liability waiver.
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Incident Management Procedure
PDF template
A comprehensive procedure for reporting, investigating, and managing workplace incidents and hazards across the organization.
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Corps Of Cadets Preparticipation Physical Evaluation Medical History
PDF template
Medical history and health evaluation form required for admission to the Texas A&M Corps of Cadets, verifying medical fitness for cadet program participation.
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Corrected (Replacement)Voided Claim Request Form
PDF template
A form used to correct or void previously processed healthcare claims with specific submission requirements.
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Counseling Consent Form
PDF template
A consent form for parents to authorize counseling for their child by a graduate student counselor at Alfred University.
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Courier Delivery Form For FAVN Results
PDF template
A form for requesting delivery of FAVN test results via shipping account or credit card payment for international and domestic shipping.
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RPCI.GEN.LAB.PATH.Frm.0023.00 Delivery Form
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A form for tracking and delivering medical laboratory samples between locations.
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Course Placement Waiver Form
PDF template
A form allowing students and parents to request course placement that differs from school recommendations, acknowledging potential academic risks.
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PETITION FOR COURSE SUBSTITUTION OR WAIVER FORM
PDF template
A form for students to request course substitutions or waivers in their academic degree requirements.
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Course Waiver Form
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A form for students to request a waiver of a required course in their academic program through departmental recommendation.
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Course Waiver Request
PDF template
A form for students to request a waiver from specific course requirements, requiring multiple approvals from academic officials.
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Course Waiver Form
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A form for students to request waiving a course requirement based on previous course completion at another institution.
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Course Waiver Form
PDF template
A form for students to request a waiver for a required course in their academic degree program.
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Waiver Form
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A comprehensive waiver form for participation in camp activities, requiring participant information and acknowledging potential risks.
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Waiver Form
PDF template
A comprehensive waiver document for participants at Covenant Harbor Bible Camp and Retreat Center, covering liability and participation risks.
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Medical And Photographic Image Release Form
PDF template
Combined medical consent and photographic release form for students participating in university training programs
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COVID 19 Vaccination Record And Consent Form
PDF template
A form for documenting COVID-19 vaccination consent, administration details, and patient information for care home residents.
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COVID 19 Case Interview Form
PDF template
A detailed medical form used by the Florida Department of Health to collect information about COVID-19 cases and patient symptoms.
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COVID 19 DISABILITY FORM
PDF template
A comprehensive medical information form designed to help healthcare providers understand and support patients with disabilities during COVID-19 related medical treatment.
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Medical Information Request Form For COVID 19 Temporary Reasonable Accommodation For Faculty, Admini
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Form for Fordham University employees to request workplace accommodations related to COVID-19 high-risk medical conditions
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COVID 19 OTC Test Reimbursement Form
PDF template
Form for submitting reimbursement claims for personally purchased FDA-approved COVID-19 over-the-counter tests.
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COVID 19 PERSONAL HEALTH RISK ASSESSMENT FORM
PDF template
A comprehensive form to assess individual health risks and COVID-19 exposure for meeting participation and travel to Italy.
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DOH COVID 19 Vaccination Consent Form
PDF template
A comprehensive form for collecting patient information and screening for COVID-19 vaccination eligibility.
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Risk Assessment Form For COVID 19 Contact
PDF template
A form for documenting potential COVID-19 exposure and health status for university students and staff.
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COVID 19 SPECIMEN SUBMISSION FORM
PDF template
Form for submitting COVID-19 test specimens to the Massachusetts State Public Health Laboratory for PCR testing.
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COVID 19 TESTING PATIENT INTAKE FORM
PDF template
Demographic and medical intake form for COVID-19 testing in compliance with CARES Act reporting requirements.
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Communicable Disease Related Hold Harmless, Release, Waiver Of Liability, And Indemnity Agreement
PDF template
Legal document releasing event organizers from liability related to potential communicable disease exposure during an event.
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COVID 19 Order Form
PDF template
Medical form for collecting patient information and COVID-19 specimen details for testing purposes.
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COVID 19 Release Of Liability Form
PDF template
Release of liability form for Pacific Crest Trail Association volunteers during COVID-19 pandemic, outlining risks and participant responsibilities.
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Risk Assessment Form
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Risk assessment for cash transactions during COVID-19 pandemic, outlining hazards and control measures for staff and customers.
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Vaccine Recipient Information And Consent Form
PDF template
A medical consent form for receiving COVID-19 vaccines, capturing patient information and legal authorization for vaccination services.
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COVID 19 Vaccine Consent And Waiver Form
PDF template
A legal consent form for receiving the COVID-19 vaccine, detailing risks, acknowledgements, and patient agreements.
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PARENTALGUARDIAN, SCOUT, LEADER COVID 19 ACKNOWLEDGEMENT CONSENT WAIVER FORM
PDF template
A waiver form acknowledging COVID-19 risks for scout activities and granting permission for participation during the pandemic.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients at a women's wellness practice, collecting personal and medical information.
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Medical Form For Volunteers
PDF template
A comprehensive medical screening form for volunteers to assess health status and eligibility for participation in Camp Promise/Jett Foundation programs.
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Medical Form For Campers
PDF template
A comprehensive medical form for documenting a camper's health status, medical history, and physical examination details for participation in Camp Promise/Jett Foundation programs.
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CPJ Emergencies Risk Assessment Template
PDF template
A comprehensive risk assessment template for journalists to evaluate potential safety risks and develop mitigation strategies for reporting assignments.
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Center For Pediatric Therapies Volunteer Application Form
PDF template
A comprehensive application form for potential volunteers at the Center for Pediatric Therapies, including medical and contact information.
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CRAFFTN Interview Form
PDF template
A confidential medical screening form for assessing substance use and potential risks among adolescents or young adults.
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Physical Examination Form
PDF template
Comprehensive medical examination form for assessing physical fitness, likely for occupational certification purposes.
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Caries Risk Assessment Form For Ages 6 Years Through Adult
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A medical form assessing a patient's risk for dental decay and providing recommended preventive care instructions.
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Patient Medical Intake Form
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Medical intake and financial responsibility form for orthopedic patient evaluation, specifically for injury-related medical treatment.
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Credit Card Authorization Form
PDF template
A form for submitting payment for rabies testing services at Kansas State University Veterinary Diagnostic Laboratory.
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Credit Card Pre Authorization Form
PDF template
A form authorizing Creekside Counseling + Wellness to charge client's credit card for services, copayments, and fees.
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Credit Card Pre Authorization Form
PDF template
Form authorizing Valleycare Gastroenterology Medical Group to charge credit card for patient balances and medical services
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Data Protection Policy
PDF template
A comprehensive policy outlining how CRESS handles, protects, and manages personal data in compliance with Data Protection Act and GDPR regulations.
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Clinical Research Education Training Program (CRETP) Application Student Evaluation Form
PDF template
A form used to evaluate student characteristics and potential for participation in a clinical research training program.
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Criminal Background Check Consent Form
PDF template
Consent form allowing Hereford Faith & Life Church to obtain a criminal background report for employment or volunteer purposes.
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Criminal Background Check Consent Form
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A consent form authorizing criminal history record information retrieval for employment or school-related purposes in the Calhoun City School System.
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Criminal Background Check Waiver Release Form
PDF template
A form for housing applicants to authorize a criminal background check and provide necessary documentation for Texas State Technical College housing application.
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Criminal Background Check Waiver Release Form
PDF template
A form for housing applicants to authorize a criminal background check and release liability for Texas State Technical College.
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CREDITCRIMINAL BACKGROUND CHECK CONSENT FORM
PDF template
A consent form allowing Rent Grow to conduct a criminal background check for property management screening purposes.
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Name Based Criminal History Record Information ConsentInquiry Form
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A form authorizing a criminal history background check for various employment and personal purposes in Georgia.
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Name Based Criminal History Record Information ConsentInquiry Form
PDF template
A form authorizing a criminal history record information inquiry and background check for various purposes such as employment or working with specific populations.
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Name Based Criminal History Record Information (CHRI) ConsentInquiry Form
PDF template
A consent form for conducting criminal history record checks for various employment and personal purposes in Georgia.
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Criminal Records Background Check Consent Form
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A consent form for criminal background checks for potential employees and volunteers with Portland Parks & Recreation
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PhysicianS Mammography Evaluation Form
PDF template
Detailed assessment form for evaluating mammography image quality and technical standards.
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DMMA Critical Incident Form
PDF template
A comprehensive form for documenting and reporting critical incidents involving healthcare members or patients.
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Advance Conflict Waiver Form Language
PDF template
A document outlining potential conflict of interest scenarios in legal representation for financial transactions.
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Informed Consent Self Assessment Form
PDF template
An electronically fillable PDF version of the Informed Consent Self-Assessment tool to help study teams evaluate their informed consent process.
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CLINICAL GENETICS PROGRAM REFERRAL FORM (GENERALPRENATAL)
PDF template
A medical referral form for genetic consultation and testing services, used by healthcare providers to submit patient referrals for genetic assessment.
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Hepatitis C Virus (HCV) Treatment Procedure
PDF template
Montana Department of Corrections clinical procedure for monitoring and treating Hepatitis C Virus among offenders in secure care facilities.
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Cranleigh School Equestrian Centre Booking Form
PDF template
Booking and registration form for riders at Cranleigh School Equestrian Centre, capturing participant and emergency contact details.
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Committee For Specialist International Medical Graduate Education (CSIMGE) Area Of Need Ongoing Asse
PDF template
Comprehensive evaluation form for assessing international medical graduates' clinical performance, professional skills, and competencies in a medical setting.
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Employer Support Declaration Form
PDF template
A form documenting employer support for an international medical graduate's pathway to fellowship with the Royal Australian and New Zealand College of Psychiatrists (RANZCP)
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Required Consent For Release Of Information
PDF template
A consent form for releasing a child's medical, mental health, and treatment information for intensive mental health services coordination in New York City.
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CSS Profile Waiver Request For The Noncustodial Parent
PDF template
A form allowing students to request a waiver for noncustodial parent financial information when applying for financial aid.
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Profile Waiver Request For The Noncustodial Parent
PDF template
A form for students to request a waiver of the CSS Profile requirement for a noncustodial parent in specific circumstances such as abuse or no contact.
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CSS Profile Waiver Request For The Noncustodial Parent
PDF template
A form for students seeking to waive the requirement of obtaining CSS Profile information from a noncustodial parent in financial aid applications.
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Media Release Form
PDF template
A consent form allowing Columbia School of Social Work to record, publish, and use media from events for educational purposes.
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Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document waiving liability for participation in University of California community service transportation program.
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Colorado State University Pueblo Event ParticipationMedical Form
PDF template
Comprehensive medical form for capturing participant health information, emergency contacts, and medical history for Colorado State University Pueblo events.
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Circulating Tumor Cell Core Laboratory Requisition Form
PDF template
A requisition form for submitting samples to the Circulating Tumor Cell Core Laboratory for enumeration and profile analysis.
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Utah FCCLA Media Release Form
PDF template
A comprehensive media release form granting permission for photography, digital media use, and reproduction for educational and promotional purposes.
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CTE Hospital Occupations Internship Class Application Form
PDF template
Application for high school students to participate in a medical internship program at UCI Medical Center, involving job shadowing and clinical skills training.
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CT, MRI And MRA Order Pre Authorization Form
PDF template
A comprehensive form for ordering CT, MRI, and MRA medical imaging exams with detailed patient and clinical information requirements.
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CPT Codes List
PDF template
Comprehensive list of Current Procedural Terminology (CPT) codes for various CT and diagnostic imaging procedures.
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Nebraska Career Student Organization Medical Release Form
PDF template
A medical consent and emergency contact form for student organization members, allowing medical treatment authorization in parent/guardian's absence.
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Cub Scout Activity Waiver Form
PDF template
A waiver form for youth and adult participation in Cub Scout activities, addressing medical and safety requirements.
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Attending Physician Statement
PDF template
Medical documentation form used to assess patient's medical condition and ability to work for disability evaluation purposes.
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CUNY Off Campus Activity Participation, Waiver, And Emergency Contact Form (Domestic Travel)
PDF template
A form for students to acknowledge risks and provide emergency contact information for off-campus activities at CUNY.
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CUNY Release Agreement For Activities In A Destination Under A Travel Warning
PDF template
A legal document outlining risk assumptions and compliance requirements for CUNY travelers going to destinations with travel warnings or advisories.
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SHORT TERM DISABILITY CLAIM FORM
PDF template
Form for employees to file a claim for short-term disability benefits, including personal and employment details.
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Payment Request Form
PDF template
A form for requesting payment for self-directed services within a Medicaid waiver program, requiring detailed vendor and service information.
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Participant Consumption Of Alcohol Information And Waiver Form
PDF template
A form outlining alcohol consumption guidelines and restrictions for adult participants in Champaign-Urbana Special Recreation activities.
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CUHSR Approved Informed Consent Form Language For Research Studies Using Participant Incentives
PDF template
Guidelines for documenting participant compensation and tax implications in research studies at Bradley University
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Custodian Consent Form
PDF template
A form outlining the responsibilities and obligations of a custodian for broker-dealer books and records during a withdrawal process.
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Short Tissue Repository Research Consent Form
PDF template
Consent form for patients to participate in a genetic research biorepository studying cardiovascular health and disease factors.
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REFERRAL FORM B Specialist
PDF template
A medical referral form used by Citrus Valley Physicians Group to request specialist services and track patient referrals.
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Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, including patient and pharmacy information, insurance details, and claim reasons.
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Accident Waiver, Release Of Liability Informed Consent Form
PDF template
Legal document waiving liability for participants in activities at the Colonial Williamsburg Musket Range.
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Accident Waiver, Release Of Liability Informed Consent Form
PDF template
Legal document waiving liability for participants in activities at the Colonial Williamsburg Musket Range.
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Patient Registration Form
PDF template
A comprehensive medical intake form for collecting patient personal and insurance details for healthcare services.
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Application For Appointment In Cytopathology Fellowship Program
PDF template
Application form for medical professionals seeking a fellowship in cytopathology at the University of Massachusetts Medical School/UMass Memorial Health Care.
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Pathology Requisition Cytology
PDF template
Medical form for collecting patient cytology test information, clinical history, and diagnostic details for gynecological testing.
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Attachment 1 32 Forms Now Available For Download Only
PDF template
Comprehensive list of 32 medical, consent, and administrative forms for healthcare and government services.
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The National Rental Affordability Scheme Tenant Demographic Assessment And Consent Form
PDF template
A form for collecting tenant information to assess eligibility for the National Rental Affordability Scheme (NRAS) rental properties.
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Consent For The Medical Treatment Of A Minor
PDF template
A consent form authorizing medical treatment for a minor student at Sam Houston State University Health Center with payment responsibility details.
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Request For Records Disposition Authority
PDF template
Official document detailing records disposition for Commissioned Corps Officers in the U.S. Department of Health and Human Services.
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Medical Form Requirements
PDF template
Comprehensive guide for medical form requirements for Boy Scouts of America camps and activities in Colorado.
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RISK ASSESSMENT FORM
PDF template
Comprehensive risk assessment document evaluating safety risks and mitigation strategies for a visitor ride attraction.
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MEDICAL INQUIRY FORM IN RESPONSE TO AN ACCOMMODATION REQUEST
PDF template
A medical form used to assess an employee's disability status and potential need for workplace accommodations under the Americans with Disabilities Act (ADA).
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PARKING ACCOMMODATION STATEMENT OF MEDICAL NECESSITY
PDF template
Medical certification form for employees requesting parking accommodations due to disability or medical limitations
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New Provider Data Form
PDF template
Comprehensive registration form for medical providers to submit personal and professional information for onboarding with CHS Medical Group.
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New Provider Data Form
PDF template
Comprehensive form for medical providers to submit personal and professional information for registration with CHS Medical Group.
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Data Privacy High Volume Consent Form Areas Checklist
PDF template
A comprehensive checklist for identifying potential high-volume consent form areas within an institutional setting.
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PCO Data Protection And Privacy Policy
PDF template
A comprehensive policy detailing how MCI Suisse SA collects, processes, and protects personal data in their event and association management services.
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WESTON BEGGARD PARISH COUNCIL CONSENT FORM
PDF template
A consent form for individuals to authorize communication methods and data usage by the Weston Beggard Parish Council.
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WELSH NEWTON AND LLANROTHAL GROUP PARISH COUNCIL CONSENT FORM KEEPING IN TOUCH
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A consent form for individuals to agree to receive communications from the Welsh Newton and Llanrothal Group Parish Council through various channels.
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Data Protection Consent Form
PDF template
A form for members of Merthyr West End Bowling Club to provide consent for data storage, publication, and image usage.
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Data Protection Act 2018 Consent Form
PDF template
Consent form for personal data processing and communication preferences for Bodenham Parish Council.
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CRONTON PARISH COUNCIL CONSENT FORM
PDF template
A form for obtaining consent from individuals to receive communications from the local parish council through various channels.
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Data Protection Consent Form
PDF template
Consent form for personal data processing by Sleeping Dragon Acupuncture, outlining data usage, storage, and protection terms.
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Data Protection Consent Form Privacy Policy
PDF template
A comprehensive privacy policy detailing data collection, processing, usage, and user rights for the Atos Data Protection Consent Form website.
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Data Protection Consent Form Members
PDF template
Consent form for members of the Southwell and Nottingham Diocesan Guild of Church Bell Ringers to collect and use personal data.
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Declaration Of Consent And Privacy Policy
PDF template
Privacy policy for participants of the Online-Conference on Social Innovation by the Federal Ministry of Education and Research (BMBF) and German Aerospace Center (DLR).
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Data Protection Notice And Joint Controller Agreement
PDF template
A comprehensive data protection notice explaining how EIT Food collects, processes, and protects personal data in compliance with GDPR.
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Data Protection Consent Form Tower Contact
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A consent form for tower contacts to manage personal data usage by the Southwell and Nottingham Diocesan Guild of Church Bell Ringers.
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DocuSign Analyzer Datasheet
PDF template
An AI-driven tool that helps organizations analyze, negotiate, and review incoming agreements more efficiently by extracting key terms and generating risk scorecards.
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Bartlett Park District Registration Form
PDF template
Registration form for park district programs with participant information, payment details, and liability waiver.
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SSM Health Davis Duehr Dean Eye Care Referral Form
PDF template
Medical referral form for patients needing eye care services at SSM Davis Duehr Dean Eye Care clinic, used to transmit patient and clinical information.
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Interpreter Evaluation Form
PDF template
A comprehensive form to evaluate the performance and skills of medical interpreters across multiple dimensions of communication and professionalism.
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Emergency Consent Form
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A medical consent form that allows parents or guardians to provide advance authorization for emergency medical treatment of a child.
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Text Messaging Consent Form
PDF template
A consent form outlining risks, conditions, and client responsibilities for text message communication with Deschutes County.
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RETIRED LAW ENFORCEMENT OFFICER IDENTIFICATION CARD
PDF template
Liability waiver for retired law enforcement officers seeking to carry a concealed firearm under LEOSA provisions.
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Emergency Medical Release
PDF template
A comprehensive medical release form for participants, collecting emergency contact, health, and treatment authorization information for minors.
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Adult Patient Intake Form
PDF template
A comprehensive form for collecting patient medical history, personal information, and health details for treatment planning.
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Dekalb County Athletic Participation Consent Form
PDF template
Parental consent form for students participating in inter-scholastic athletics and sports clubs in DeKalb County School District.
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DCTD Tumor Repository International Shipping Form
PDF template
A form for shipping tumor repository samples internationally, used by researchers to request and document biological material shipments.
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Uniform Consultation Referral Form
PDF template
A comprehensive form for healthcare providers to refer patients to consultants, detailing patient, provider, and referral information.
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DD FORM 2789
PDF template
A Department of Defense form for requesting waiver or remission of financial indebtedness for military and civilian personnel.
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DD Form 2807 2 Medical Prescreen Of Medical History Report
PDF template
A form used by military recruiters to pre-screen medical history of potential military service applicants for the United States Armed Forces or Coast Guard.
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DD FORM 2876 3, TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGER (PCM) CHANGE FORM
PDF template
Official Department of Defense form for enrolling, disenrolling, or changing primary care managers in the TRICARE Prime healthcare program.
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DD FORM 2876 TRICARE PRIME ENROLLMENT, DISENROLLMENT, AND PRIMARY CARE MANAGER (PCM) CHANGE FORM
PDF template
A Department of Defense form for enrolling, disenrolling, or changing primary care managers in the TRICARE Prime healthcare program.
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Waiver Of Notice Of Proposed Action
PDF template
Legal form allowing waiver of notice rights for actions in estate administration by a personal representative.
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DEA Order Form 222
PDF template
Official form for ordering Schedule I and II controlled substances from authorized suppliers, requiring detailed tracking and record-keeping.
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Privacy Policy
PDF template
A comprehensive policy detailing how DEAC collects, uses, and manages personal information from various sources and interactions.
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DECA ICDC 2023 Registration Guide
PDF template
Official registration and permission form for DECA conference attendance, including medical authorization and conduct agreement.
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Diver Medical Questionnaire Additional Declarations COVID 19
PDF template
A medical questionnaire and health declaration form for divers to assess fitness and COVID-19 risk prior to participating in diving activities.
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Decode Duchenne Test Requisition Form
PDF template
A comprehensive genetic testing requisition form for patients with suspected or confirmed Duchenne or Becker muscular dystrophy
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Participant Agreement, Release And Assumption Of Risk
PDF template
Legal waiver and risk assumption document for participants in trampoline and interactive activities, specifically for participants under 19 years old.
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BIRTH TO TWENTY DELIVERY FORM
PDF template
Comprehensive medical form documenting pregnancy and childbirth details for medical research and tracking.
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Dental Claim Form
PDF template
A standardized form for submitting dental insurance claims, tracking patient treatment, and requesting predetermination or preauthorization.
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Patient Intake Form
PDF template
Comprehensive patient registration form collecting personal, contact, and insurance information for medical practice.
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Demographics And Insurance Form Surgery Registration
PDF template
Comprehensive patient intake form for surgical procedures, collecting patient demographics, insurance, and medical contact information.
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DENTAL CONE BEAM CT REFERRAL FORM
PDF template
A medical referral form for dental cone beam CT imaging studies with patient and physician information collection.
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Consent For Dental Procedure And Acknowledgment Of Receipt Of Information
PDF template
A comprehensive consent form for parents or guardians to authorize dental procedures for children at Brooker Memorial Children's Dental Center.
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Proof Of School Dental Examination Form
PDF template
Official form documenting student dental health examination for Illinois school children in specific grade levels as required by state law.
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Dental Examination Waiver Form
PDF template
A form for parents or guardians to request a waiver for required dental examinations for students in Illinois schools.
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Dental Examination Waiver Form
PDF template
A form for parents/guardians to request a waiver from required dental examination for school-enrolled children in Illinois.
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Dental Examination Waiver Form
PDF template
A form allowing parents/guardians to request a waiver for required dental examinations for students due to specific insurance or access constraints.
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WCTC Dental Hygiene Clinic MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for patients at a dental hygiene clinic, collecting personal information and medical conditions.
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Dental Hygiene Consent Form
PDF template
A comprehensive consent form outlining patient expectations, treatment policies, and administrative guidelines for dental services.
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Dental Waiver Form
PDF template
A form allowing civil service staff to waive enrollment in Genesee Community College's group dental insurance plan.
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PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical and dental history form for patient intake, collecting personal health information and current medical status.
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Dental Medical Release Form Template
PDF template
A template form for patients to authorize medical information release and consent for dental treatment.
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Kentucky Dental ScreeningExamination Form For School Entry
PDF template
A mandatory dental health screening form for children entering public school in Kentucky, documenting dental health status and examination details.
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Patient Referral Form
PDF template
A comprehensive medical and dental referral form for patient intake and specialist consultation at Boston Children's Hospital dental services.
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Medical History Form
PDF template
Comprehensive medical history form collecting personal health information, medical background, and current health status.
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Consent To Release Private Data For Recreational Vehicle Registration Renewal
PDF template
A consent form allowing release of private electronic licensing system data for vehicle registration renewal by the Minnesota Department of Natural Resources.
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Dermatology Medical History
PDF template
Comprehensive medical history form for dermatology patients to document health conditions, medications, and allergies.
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DERMATOLOGY MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for dermatology patients to document existing health conditions, medications, and potential skin-related medical concerns.
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Dermatopathology Requisition Form
PDF template
Medical form for submitting wet or fresh tissue specimens for dermatopathology analysis and diagnostic testing.
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Des Plaines Park District Waiver Form
PDF template
Waiver and release form for sports team participants to acknowledge and accept potential risks associated with participation.
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Device Delivery Form
PDF template
A form documenting the loan of devices, capturing recipient details and liability agreements for device usage and personal data processing.
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Shipping Assessment Form
PDF template
A comprehensive form for assessing and documenting shipments of various materials to and from Weill Cornell Medicine, requiring detailed information about shipping contents and requirements.
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CONSENT FORM CONFIDENTIAL HUMAN IMMUNODEFICIENCY VIRUS (HIV) TEST Non Health Care Settings
PDF template
Official consent form for HIV testing in non-healthcare settings, documenting informed consent and explaining testing procedures.
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REFERRAL FOR CONSULT OR PROCEDURE
PDF template
Medical referral form for patients seeking consultation or procedures at Stanford Health Care's Digestive Health and Liver Clinic
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Patient Medical History Form
PDF template
Comprehensive medical history form for collecting patient personal information, contact details, and health status.
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Type 2 Diabetes Risk Assessment Form
PDF template
A screening tool to evaluate an individual's risk factors for developing type 2 diabetes through a points-based assessment.
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Request For Diagnostic Imaging
PDF template
Medical form for requesting and scheduling diagnostic imaging procedures such as X-Ray, Ultrasound, CT, and Nuclear Medicine.
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NWU2014 04 01 Participant Contact Form Data Dictionary
PDF template
A data dictionary for documenting participant contact form variables and metadata for a research study.
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MDA2016 08 02 Study Specimen Shipping Form Blood Data Dictionary
PDF template
A data dictionary detailing the variables and specifications for a blood specimen shipping form used in a medical study.
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MDA2014 04 01 Specimen Shipping Form Tissue Data Dictionary
PDF template
A comprehensive data dictionary for tracking and recording specimen shipping information for tissue samples across multiple medical institutions.
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Student Record Card 6
PDF template
A health record and immunization documentation form required for student enrollment in Montgomery County Public Schools in Maryland.
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Stanford Health Care Referral For Consult Or Procedure
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A medical referral document for patients seeking consultation or procedures at Stanford Digestive Health and Liver Clinic.
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FEMME PHYSIOCARE PATIENT INTAKE FORM
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Comprehensive patient intake form for physiotherapy services with personal information, insurance, and consent sections.
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DIGITAL SLIDE ORDER REQUEST FORM
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A form for requesting digital slide scanning services at UCLA with options for magnification, scanner type, and image delivery method.
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DIRECT ACCESS PATIENT ATTESTATION AND MEDICAL RELEASE FORM
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A form for patients seeking physical therapy care, documenting current medical care status and providing medical record release consent.
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Athlete Registration Form, Athlete Release Form Athlete Medical Forms
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Detailed guide for completing and submitting athlete registration and medical documentation for participation.
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Molina Healthcare Of California Direct Referral To Specialist
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A referral form for Molina Healthcare members to receive specialized medical services within their network of contracted specialists.
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VCHCP PCP DIRECT REFERRAL FORM
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A medical referral form for primary care physicians to refer patients to contracted specialists within the Ventura County Health Care Plan network.
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DIS 101C V7 EMPLOYEE STATEMENT DISABILITY CLAIM FORM
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A comprehensive form for employees to file a disability claim for short-term or long-term disability benefits.
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SUPPLEMENTAL DISABILITY CLAIM FORM
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Claim form for submitting a disability benefit request for IUOE Local 132 Health and Welfare Fund participants
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Disability Claim Form
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A comprehensive form for submitting a disability insurance claim, detailing the policyholder's medical condition and disability status.
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Delta Pilots Mutual Aid Disability Claim Form
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Disability claim form for Delta pilots to request benefits and authorize medical information release and payment processing.
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Short Term Disability Claim Form
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A comprehensive form for employees to file a claim for short-term disability benefits, requiring input from the employee, employer, and attending physician.
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Disability Claim Form Instructions
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Comprehensive instructions for filing a disability insurance claim with sections for physician, claimant, and employer statements.
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Disability Claim Form
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A comprehensive form for filing a disability claim with medical and employment details for Teamsters Joint Council No. 83 members.
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Disability Claim Form
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A comprehensive form for filing a disability claim through the Teamsters Joint Council No. 83 of Virginia Health & Welfare and Pension Funds.
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Continuing Disability Claim Form
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A comprehensive form for filing a disability insurance claim covering various types of disability and patient information
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N 648 Medical Certification For Disability Exceptions
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Guidelines for medical professionals assessing disability exceptions for refugees seeking U.S. citizenship, focusing on comprehensive and culturally sensitive evaluation methods.
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Short Term Disability Reporting Form
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A reporting form for employees to document short-term disability leave and absence from work due to illness or non-work related injury.
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Supplementary Disability Claim Form
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A form used to submit disability claims, requiring details from both the claimant and attending physician about an employee's inability to work.
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SI 11268 Your Disability Benefit Claim
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Application packet for submitting a long-term disability benefits claim, including instructions for completing required forms.
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Certification For Tuition Waiver Form
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A form for students with permanent disabilities to request a tuition waiver based on social security disability benefits.
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Adapted Physical Education Program Medical Form
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Medical form documenting student's disability, exercise limitations, and physical capabilities for adapted physical education program participation.
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Guide For Tuition Waiver For Students With Disabilities
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A guide explaining tuition waiver eligibility for Maryland residents with permanent disabilities who wish to enroll in community college courses.
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How To File A Claim For Weekly Disability Benefits
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Comprehensive guide for filing a disability benefits claim, including required documentation and medical certification requirements.
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Discharge Form
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A form used to document patient discharge from a healthcare facility with multiple completion options.
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Discharge And Follow Up Recommendations
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Guidelines for healthcare personnel on discharge and follow-up care for patients who have experienced assault, including medical and mental health considerations.
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DISCHARGE PLANNING INPATIENT STANDARDS
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A comprehensive protocol detailing the procedures and responsibilities for patient discharge from an inpatient healthcare facility.
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Pediatric Discharge Summary Template
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A comprehensive template and instructions for creating a pediatric patient discharge summary with detailed guidelines for documentation.
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Discussion Period Request Form
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Form for healthcare providers to request a review of a claim determination and provide additional supporting documentation within a 30-day period.
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International Medical History Form
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Comprehensive medical form for collecting personal health information, emergency contacts, and medical history for international travel purposes.
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Gooding Schools Extracurricular Consent Form
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A consent form for students participating in school extracurricular activities, including drug testing requirements.
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MLML AAUS Diving Medical Form
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Medical examination form for assessing fitness of scientific divers, detailing potential disqualifying medical conditions for diving certification.
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DIVING MEDICAL HISTORY FORM
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A comprehensive medical history form designed to assess an individual's fitness and health risks for participating in scuba diving activities.
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UM Diver Proof Of Insurance Form
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Form requiring proof of medical insurance coverage for potential scuba diving accidents and hyperbaric oxygen therapy
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UM Diver Proof Of Insurance Form
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A form requiring divers to prove they have medical insurance coverage for potential scuba diving accidents involving hyperbaric oxygen therapy.
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DIZZINESS BALANCE MEDICAL HISTORY QUESTIONNAIRE
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Comprehensive medical questionnaire for patients experiencing dizziness, balance issues, and related symptoms
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College Credit Waiver Application
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Application for law enforcement officers to request waiver of college credit requirements in Wisconsin.
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PI Request To Purchase DrugsSupplies From DLAM
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A form for principal investigators to request drugs or supplies through the Division of Laboratory Animal Medicine (DLAM)
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NC Medicaid Hospice Prior Approval Authorization Form
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A form for healthcare providers to request prior authorization for Medicaid hospice benefits for patients entering a new benefit period.
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DMA 5044 Consent For Release Of Information
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A form allowing an individual to authorize the release of personal information to a County Department of Social Services for eligibility determination.
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CCNCCA Enrollment Form
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Enrollment form for healthcare program participation, allowing individuals to enroll multiple people and select primary care providers.
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Individual Volunteer Registration AgreementTime Record
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Agreement for volunteers to register and track service time with the Department of Natural Resources, including liability waiver and image consent.
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2023 24 CONSENT TO TREAT FORM
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Parental consent form allowing medical providers to treat minor athletes during sports-related activities when parents are unavailable.
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Media Release Form
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Official form granting the State of Alaska permission to use an individual's photographic, video, or verbal content for public communication purposes.
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Sample Verification Consent Form
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Consent form for noncitizen family members to verify eligible immigration status for housing financial assistance.
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Disclosure Relating To Electronic Services Online Services Agreement
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Terms and conditions governing the use of Legal & General America's online services and website, including user consent and agreement to digital interactions.
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Referral
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A comprehensive medical referral document for tracking patient information and transfer of care between healthcare providers.
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DoctorS Signature Form
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A comprehensive medical form for documenting a camper's health information, medical history, medications, and physician details.
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Organizational Hold Harmless And Indemnity Agreement
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Legal document that provides liability protection for Boy Scouts of America against claims from non-BSA scouting groups and organizations.
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Drug Testing Consent Form
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A consent form for drug testing for individuals contracted with the Suwannee River Area Council of Boy Scouts of America.
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Boarding Agreement Form
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A comprehensive agreement for pet boarding services covering vaccinations, medical emergencies, and facility policies
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Minor (Under 18) Participant Form
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Registration and liability waiver form for minors participating in sports activities at Accelerate Sports complex.
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HUD 9887A Fact Sheet
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Document package for obtaining consent from housing assistance applicants to verify personal information with various government agencies.
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Tips And Tricks For Writing Your Ethics Application Documents
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A comprehensive guide for researchers preparing ethics application documents, covering key components like study protocol, letter of information, and consent forms.
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Document Waiver Form
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A form for applicants to request waiver of required submittal documents when applying for building permits online.
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Electronic Record And Signature Disclosure
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Legal document outlining electronic communication and signature consent for Polam Federal Credit Union members.
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The 1st Annual Ridgecrest Regional Hospital Dodgeball Tournament 2017 Waiver Form
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Legal waiver for participants in the Ridgecrest Regional Hospital Dodgeball Tournament, releasing the hospital from liability for potential injuries.
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Authorization For The Release Of Health Information And Confidential HIV Related Information DOH 255
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A form for releasing general health and HIV-related information to single or multiple healthcare providers with specific guidelines for usage.
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Authorization For Use Or Disclosure Of Protected Health Information (PHI)
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A legal form allowing authorized use and disclosure of an individual's protected health information by the Hawaii State Department of Health.
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DOH COVID 19 Vaccination Consent Form
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A comprehensive form for capturing patient information and screening for COVID-19 vaccination eligibility and potential health risks.
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Build America, Buy America Act (BABAA) Domestic Sourcing Requirements Waiver Request Form
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A form for requesting a waiver from domestic sourcing requirements for Department of Education grant programs under the Build America, Buy America Act.
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RELEASE INDEMNIFICATION FOR DOMESTIC TRAVEL FORM
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A legal document for releasing liability and indemnifying the university for domestic student travel activities.
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DOMESTIC ANIMAL Vs. WILD MAMMAL INCIDENT REPORT FORM
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Form for documenting interactions between domestic animals and wild mammals that could potentially involve rabies transmission.
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INFORMED CONSENT TO DONATE EMBRYOSWAIVER OF LIABILITY
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Legal document for donating cryopreserved embryos to the National Embryo Donation Center for reproductive purposes.
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Do Not File Insurance Waiver Form
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A document allowing patients to request that Oklahoma State University Medicine not file an insurance claim for a specific date of service.
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EducationalAcademic Travel Pre Authorization Form For Out Of Province Travel
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A pre-approval form for faculty, clinical associates, and trainees to document and obtain approval for out-of-province travel related to educational or academic purposes.
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I 612, Application For Waiver Of The Foreign Residence Requirement
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Instructions for applying for a waiver of the two-year foreign residence requirement for certain exchange visitors seeking immigration or visa status.
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TESTING REQUISITION FORM
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Specialized medical form for flow cytometry testing of blood and bone marrow specimens for various hematological conditions.
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Oklahoma Department Of Public Safety Driver Data Information Request
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A form for requesting driver information from the Oklahoma Department of Public Safety for various authorized purposes such as insurance claims, employment, and other permitted uses.
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Design A Consent Form
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A guide for creating consent forms that clearly establish service expectations and information collection terms, based on New Zealand's Data Protection and Use Policy.
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Driver Medical History Form
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Medical history and physical examination form for taxi and limousine drivers to assess fitness for operating a motor vehicle.
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Chapter 133. General Medical Provisions Subchapter B. Health Care Provider Billing Procedures
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Regulatory document specifying required electronic and paper billing formats for healthcare providers in workers' compensation and insurance contexts.
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Artist ApplicationAgreement
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A legal document for artist participation in Buttonwood Art Space activities, including a waiver of liability and hold harmless agreement.
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Generic Risk Assessment Form V.1 Nov08
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A detailed risk assessment form examining the potential for vertigo and balance loss when moving quickly near strong magnetic fields in MRI settings.
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Medical Certification Form New Driver Applicant
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Medical certification document required for new taxi and livery vehicle drivers in New York City to verify physical fitness for driving.
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Integrative Medicine Intake Form
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Comprehensive medical intake form for patients seeking integrative medicine services, collecting medical history, current health concerns, and personal health information.
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Medical Drop Off Consent Form
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A consent form for veterinary medical services and pet drop-off, including pet health status and treatment authorization.
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Drug Testing Consent NCAA Division III
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Consent form for NCAA Division III student-athletes agreeing to drug testing and understanding potential consequences of positive tests.
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Student Drug Testing Consent Form
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Consent form for student drug testing as a condition of participating in co- and extra-curricular activities
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Drug Testing Applicant Consent Form
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A consent form for job applicants to authorize substance screening as part of the employment application process.
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DRUG TESTING CONSENT FORM
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Consent form for drug testing as a condition of employment with Haywood County Consolidated School System.
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Drug Testing Consent
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A consent form for employees to voluntarily submit to drug testing, acknowledging potential disciplinary consequences and confidentiality protocols.
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Drug Testing Consent Form
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A comprehensive consent form for drug testing administered by the Manila Health Department Public Health Laboratory for various purposes.
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Pre Employment Drug Testing Consent Form
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A consent form for job applicants to undergo mandatory pre-employment drug testing as a condition of employment at The Larkin Center.
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Drug Testing Consent
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A consent form authorizing drug and alcohol testing for employment purposes at Centurion Moving and Storage.
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Form 10 3f Drug Testing Consent NCAA Division III
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A mandatory consent form for NCAA Division III student-athletes to agree to drug testing and understand associated consequences.
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Student Drug Testing Consent Form
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A consent form for students to participate in random drug and alcohol testing as a condition of attending school-sponsored activities
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Drug Testing Consent Form
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Consent form for job applicants to undergo drug testing as a condition of employment with Reaction Co.
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Youth Membership Form (Under 18)
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A comprehensive membership form for youth under 18 to join senior and multigenerational center programs in Albuquerque.
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Medical Examination Form
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Comprehensive medical examination form documenting patient's physical condition, vision, hearing, and overall health status.
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Medical Examination For Immigrant Or Refugee Applicant (DS 2053)
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Comprehensive guide for panel physicians completing medical examinations for immigrant and refugee applicants, detailing required assessments and evaluation process.
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Student Insurance Claim Form
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A comprehensive insurance claim form for students to report medical examinations, illnesses, prescriptions, or injuries for insurance coverage.
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ConsentAuthorization Form For Child Medical ChildFamily Evaluations
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A consent form authorizing medical and family evaluations for children under child protective services assessment.
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Dual Agency Consent Agreement
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A legal document outlining consent and terms for a real estate brokerage to represent both buyer and seller in a property transaction.
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Informed Consent For Fitness Assessment
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Consent document for participating in a comprehensive fitness assessment conducted by exercise physiology students at the College of St. Scholastica during the City of Duluth Health Fair.
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Informed Consent For Fitness Assessment
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Consent document for a fitness assessment conducted by exercise physiology students at the College of St. Scholastica during a City of Duluth Health Fair.
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DyAnsys Brief Proposal Form
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A comprehensive form for researchers seeking project support and equipment loan from DyAnsys, including project details and research objectives.
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Washington State Disclosure And Background Check Consent Form
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A consent form for criminal background checks by Dynamic Language in Washington State, requiring personal and legal disclosure of criminal history.
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Employee Academic Tuition Waiver Request Form
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A form for Cameron University employees to request tuition waivers for themselves or their dependents for academic courses.
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Barcelona Portal Industry Booking Form
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Booking form for sponsorship and exhibition options at the EACTS 34th Annual Meeting virtual event in October 2020.
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Consent Authorization Form For EAP Assisters In The Federally Facilitated Marketplace
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Authorization form for consumers seeking enrollment assistance through the Marketplace, allowing interaction with Cognosante's Enrollment Assistance Program (EAP) Assisters.
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Equine Assisted Psychotherapy Informed Consent To Treat
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A consent document outlining treatment policies, confidentiality, and expectations for equine-assisted psychotherapy with Dr. Deborah S. Zwick.
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Assumption Of The Risk, Release Waiver Of Liability
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Liability waiver for participants in a research program, acknowledging risks and providing emergency consent.
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Patient Medical History
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Comprehensive medical history form for capturing patient personal information, health status, medical history, and patient rights.
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INITIAL DISABILITY CLAIM FORM
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A comprehensive form for filing disability insurance claims covering various types of disability scenarios with patient and policyholder information.
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Hazard Report Form
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A standardized form for employees to report potential workplace safety hazards and risks.
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Sponsorship Exhibition Booking Form
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Booking form for sponsorship and exhibition opportunities at the European Breast Cancer Conference (EBCC)
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Volunteer Field Trip Waiver Form
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A waiver form for volunteers participating in activities with the East Bay Regional Park District, covering liability, medical consent, and photo permissions.
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General Risk Assessment Form
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A comprehensive form for documenting organizational risks, existing controls, and risk ratings across different hazard scenarios.
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Electronic Transmission Authorization And Consent Form
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A form authorizing electronic submission and exchange of personal health information for insurance claims processing and administration.
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Comparison Of Different Methods Of Obtaining Consent Signatures
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A detailed comparison of various methods for obtaining consent signatures in research studies, including physical, DocuSign, and REDCap eConsent approaches.
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FAQ EConsent Framework
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A comprehensive guide explaining the REDCap electronic consent framework, its usage, requirements, and key considerations for research studies.
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ECU COVID 19 Human Subject Research Risk Assessment Form
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A form to evaluate and classify research protocols based on COVID-19 exposure risk levels according to OSHA guidelines.
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ECU School Of Dental Medicine Referral Form
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A comprehensive referral form for dental patients requiring specialized medical or dental services at East Carolina University School of Dental Medicine.
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Media Release Form
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Consent form for inmates to be photographed or interviewed by media, with bilingual instructions and legal release provisions.
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Motion PicturePhotograph Release Form
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Legal document granting the City of Los Angeles Economic & Workforce Development Department permission to use an individual's image, likeness, and comments in media productions.
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EDI Application Form
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Application form for healthcare providers to submit electronic Medicare claims and receive electronic remittances through the Electronic Data Interchange (EDI) system.
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DDE Enrollment Form
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Form for healthcare providers to enroll in Direct Data Entry system and request access credentials for Medicare claims processing.
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Montana Conduent EDI Provider Enrollment Form
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A form for healthcare providers to enroll in electronic data exchange and authorize billing agent/clearinghouse transactions in Montana.
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Ultrasound Informed Consent Form
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Consent form for veterinary ultrasound procedure, including potential sedation and tissue sampling authorization for pet owners.
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Guidelines On Consent Under Regulation 2016679
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Comprehensive guidelines for obtaining valid consent under the General Data Protection Regulation (GDPR)
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Education Verification Consent Form
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A form that allows students to provide consent for releasing their educational records and verification of enrollment information.
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Employee Request For Accommodation
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A form for employees to request workplace accommodations related to disabilities or medical conditions.
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Medical Reserve Corps Volunteer Application
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Application form for volunteers interested in joining the Medical Reserve Corps for public health emergency support
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Traveler Health And Medical Information
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A comprehensive guide for group leaders to collect and manage travelers' medical information and health considerations during travel programs.
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Emergency Family Medical Leave Request Form
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Detailed guidance for employees on completing timesheets and tracking Emergency Family and Medical Leave (EFML) usage and compensation.
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Extended Health Care Claim Form
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A comprehensive form for submitting medical and health care expense claims to an insurance provider, requiring detailed personal and coverage information.
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PeriodontalImplant Referral Form
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Medical referral form for periodontal and dental implant services with patient and examination details.
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STUDENT MEDICAL HISTORY
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Comprehensive medical history form for students, covering various health aspects and potential medical conditions.
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USEF Competition EHV 1 Declaration Form
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A health declaration form for horse owners and trainers to certify their horses' health status and exposure risk for EHV-1 at competitive events.
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Electronic Communication ConsentChange Form
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Form allowing homeowners to consent to receiving community newsletter electronically instead of by mail
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Consent Form For Electronic Distribution Of Benefit Materials And Notices
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A consent form allowing employees to receive electronic copies of benefit materials and notices from Michigan State University.
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Electronic Statement Disclosure Agreement
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Agreement for electronic delivery of bank statements, disclosures, and notices in lieu of paper documents
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Electronic Tax Assessment Notice Consent Form
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Form for property owners to consent to receiving tax and assessment notices electronically from the Town of Innisfail.
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Address DesignationConsent To Electronic Delivery Form
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A form for unit owners to designate their postal and electronic contact information for a condominium association.
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Consent Form For Electronic Communication
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A form allowing victims to consent to receiving electronic communications about their criminal case from the Pima County Attorney's Office.
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Purdue University Electrical Safety Program Hazard Risk Assessment
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A comprehensive form for systematically evaluating electrical safety risks and potential hazards in workplace tasks.
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EMAIL CONSENT FORM
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A consent form for residents to receive municipal and utility notices via email, acknowledging potential risks of electronic communication.
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EMERGENCY CARE AND CONTACT FORM
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A school form for collecting student medical information, emergency contacts, and parental authorization for medical care.
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Emergency Contact Health Form
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Health and emergency contact form for participants in Lake County Forest Preserve programs, including medical information and treatment authorization.
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Emergency Contact Form
PDF template
A form for collecting personal health details and emergency contact information for club or organizational trips.
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Emergency Contact Parental Consent Form
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A comprehensive form for collecting emergency contact, medical, and consent information for children in care.
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Emergency Contact Form
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A form for collecting emergency contact and medical information for volunteers participating in disaster response activities.
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Emergency Contact Form
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A comprehensive form for collecting student emergency contact details, medical information, and guardian contact information for school records.
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Student Emergency And Release Form
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Confidential form for collecting student medical information, emergency contacts, and special needs details for Howell Mountain Elementary School District.
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Emergency Contact Vendor Form
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Form for collecting emergency contact details and medical information for vendors and booth operators.
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Consent To Use Name, Photography, And Film Voice
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Permission form for media use of children's images and emergency contact information for Sloan Museum and Longway Planetarium activities
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Emergency Contact Information Form
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A document for collecting employee emergency contact details and medical information for use in urgent situations.
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Health Office Emergency Contact Form
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A comprehensive form collecting student contact, medical, and insurance information for school emergency purposes.
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Hickory Hill Member Family Emergency Contact Form
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A form for collecting emergency contact information and medical authorization for family members at a club or organization.
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EMERGENCY CONTACT FORM
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A form for collecting personal, emergency contact, and medical information for students in case of emergency situations.
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Emergency Contact Form
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A comprehensive form for recording family contacts, medical care providers, and insurance details for emergency reference.
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Emergency Information
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A comprehensive emergency contact and medical information form for students participating in university activities.
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Emergency Medical Form For Pre Clinical And Clinical Placements
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A form for clinical and pre-clinical teacher candidates to provide emergency medical and contact information for placement purposes.
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PADRE PIO ACADEMY EMERGENCY MEDICAL FORM
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A medical form for collecting student emergency contact and treatment authorization information for Padre Pio Academy.
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Emergency Medical Form
PDF template
A comprehensive form for collecting student medical information and emergency contact details with parental consent for medical treatment.
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Emergency Medical Treatment Form
PDF template
A comprehensive medical information form for emergency medical treatment and patient details, designed to be posted on a refrigerator for quick access.
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Emergency Medical Form
PDF template
Form for updating student emergency contact, insurance, and athletic participation information for school records.
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EmergencyMedical Release Authorization Form
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A form authorizing school staff to seek medical treatment for a child in case of emergency and acknowledging parental responsibility for medical expenses.
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EmergencyMedical Release Authorization Form
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Authorization form allowing school staff to seek medical treatment for a child in emergency situations with parental consent.
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Emergency Medical Release Form
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A form granting permission for emergency medical treatment for a minor at Pats Peak Ski Area, authorizing medical care in case of illness or injury.
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Emergency Medical Release Form
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A comprehensive medical form for collecting health information and emergency contact details for participants in adaptive or therapeutic horseback riding programs.
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Emergency Medical Release Form
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A form authorizing school officials to consent to medical treatment for a minor in case parents/guardians cannot be reached.
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DUTCHESS COMMUNITY COLLEGE EMERGENCY MEDICAL FORM
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A consent form allowing medical treatment for a child during a summer program, with parental emergency contact authorization.
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EmergencyMedical Authorization Waiver Form For Minor Participants
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A form authorizing emergency medical treatment and waiving liability for minor participants in a Ferris State University camp or program.
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Emeriti Reimbursement Benefit Claim Form
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Instructions for submitting healthcare reimbursement claims through Rx debit card, online portal, or paper submission.
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EMERGENCY MEDICAL FORM
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A form for parents to authorize emergency medical treatment for students and provide critical medical contact and health information.
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EMG ORDER FORM
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Medical referral form for ordering electromyography studies to diagnose nerve and muscle conditions.
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Health Insurance Claim Form
PDF template
Standard health insurance claim form for submitting patient and insurance information for medical reimbursement and processing.
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EXTERN EMERGENCY CONTACT FORM
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Form for collecting emergency contact details for external personnel or employees at a veterinary organization.
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EMPLOYEE EMERGENCY CONTACT FORM
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A comprehensive form for collecting employee personal and emergency contact details for human resources purposes.
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Employee Emergency Medical Form
PDF template
Confidential form for collecting employee emergency contact details, medical conditions, and treatment consent.
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M NCPPC Benefits EnrollmentChange Form
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Form for employees to enroll in or modify benefits, including medical, dental, and prescription plans.
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Employee And Dependent Tuition WaiverReimbursement Form
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Form for employees to request tuition waiver or reimbursement for themselves or dependents at SSU.
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Health Coverage Waiver Form
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A document allowing employees to waive health insurance coverage offered by their employer with options for alternative coverage.
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New Patient Intake Form
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Comprehensive medical form for collecting new patient health history, chronic conditions, surgical history, medications, and family medical background.
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APPLICATION FOR EMPLOYMENT
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Comprehensive employment application form for job seekers applying to La Rabida Children's Hospital.
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Application For Employment
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Employment application form for Logan County Health Services with instructions for completing the document electronically or manually.
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CENTER FOR EARLY EDUCATION AND CARE STAFF EMERGENCY CONTACT FORM
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A form for collecting emergency contact and medical information for staff members of an early education center.
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Request For Consultation
PDF template
A medical consultation request form for electron microscopy services, used to collect patient medical history, diagnostic information, and study details.
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SUSPECT RABIES INFORMATION FORM
PDF template
Guidelines and form for submitting animal specimens to New Hampshire Public Health Laboratories for rabies testing.
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EMS Payment Plan Form No Penalty No Interest
PDF template
A form for establishing an extended payment arrangement for ambulance billing with the City of Houston
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NEW PATIENT INTAKE FORM
PDF template
A comprehensive medical history form for new patients, capturing personal information, medical history, and current health concerns.
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Endocrinology Submission Form
PDF template
Comprehensive form for submitting veterinary endocrine and hormone function test samples with detailed diagnostic testing options.
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REFERRAL FORM
PDF template
A medical referral form for endocrinology patients, specifically focused on thyroid-related diagnoses and consultations.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at the UCSF Endometriosis Center, focusing on pain assessment and reproductive health.
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NeurOptimal Client Informed Consent Form
PDF template
Legal document outlining the terms and understanding of NeurOptimal brain training, emphasizing it is not a medical treatment.
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Financial Assistance Application
PDF template
A comprehensive form for patients to provide financial details and income verification for potential medical financial assistance.
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Youth Programs Mandatory Forms
PDF template
Comprehensive legal document for youth program participation, covering travel, risk, and liability waivers for participants or their guardians.
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Home Health Referral Form
PDF template
A comprehensive form for referring patients to home health services, capturing patient information, medical orders, and healthcare practitioner details.
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ENJAYMO Patient Solutions Enrollment Form
PDF template
Comprehensive patient enrollment form for ENJAYMO patient assistance program, collecting personal and insurance information.
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Enrollment Transfer Request Form
PDF template
A form for veterans to transfer their medical enrollment between VA healthcare facilities, capturing personal and contact information.
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Electronic Consent Contact Form
PDF template
A consent form allowing patients to receive medical communications via email, SMS, and phone for allergy treatment updates and appointment reminders.
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Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, contact, medical, and insurance information for healthcare providers.
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Health History Examination Form South Carolina Envirothon Program
PDF template
Comprehensive health and emergency contact form for documenting medical information and insurance details for program participants.
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Release Of Liability, Promise Not To Sue, Assumption Of Risk And Agreement To Pay Claims
PDF template
A legal document that releases a university from liability for potential injuries or damages during an activity or related travel.
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Expression Of Interest (EOI) And Data Protection Consent Form
PDF template
A form for expressing interest in the Rural Development Programme 2014-2022 (LEADER) funding process in County Mayo, Ireland.
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Youth Sports Medical History Form
PDF template
A comprehensive medical history form for youth sports participants, requiring detailed health information and medical practitioner verification.
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Consulting Physician Compliance Form
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A comprehensive medical form for evaluating patient mental capacity and terminal disease status by consulting and attending physicians.
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Law Enforcement Officers Waiver Form
PDF template
Form for Law Enforcement Officers to waive enrollment privileges in the Public Employees' Retirement System (PERS)
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NEIWPCC Subrecipient Risk Assessment Form
PDF template
A form used to assess an organization's eligibility for a collaborative subrecipient relationship with NEIWPCC by evaluating potential legal and financial risks.
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NEIWPCC EPA SUBRECIPIENT RISK ASSESSMENT FORM
PDF template
A form used to assess an organization's eligibility for a collaborative subrecipient relationship with NEIWPCC, evaluating potential risks and compliance.
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Episodic Medical Form
PDF template
A comprehensive medical intake form for students to document current health issues and medical history at Ramapo College's Health Services.
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Accident Waiver, Release Of Liability And IndemnityHold Harmless Agreement For The Use Of Loaned Equ
PDF template
Legal document releasing White Lake Community Library from liability when borrowing and using library equipment
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Waiver And Release Agreement
PDF template
A document allowing student photography and releasing the school district from liability for potential harm or damages.
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ERaf Request Form
PDF template
A form used by specialists to request an electronic Request for Authorization Form (eRAF) from Primary Care Providers for specialty care.
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Elopement Risk Assessment
PDF template
A comprehensive form to evaluate potential elopement risks for residents with dementia in a supportive living environment.
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VR 200 ERAVE Electronic Registration Process Waiver Form
PDF template
A waiver form for medical certifiers in Arkansas seeking exemption from electronic record submission requirements for death certificates.
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Canada Summer Jobs Employee Consent Form
PDF template
A mandatory form for youth employment program participation, collecting employee information and consent for program evaluation and tracking.
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ESPEN RESEARCH FELLOWSHIPS 2020 APPLICATION FORM
PDF template
Application form for research fellowship funding from ESPEN, with detailed requirements for applicants and project details.
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ESRD Incident Or Accident Report Form
PDF template
A detailed reporting form for documenting critical incidents or accidents in healthcare facilities, especially for End-Stage Renal Disease (ESRD) centers.
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MEDICAL HISTORY FORM
PDF template
A comprehensive medical history form for patients aged 12 and older, used in combination with a referral form and unique reference number (URN).
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Authorization To Release Or Request ConfidentialHealth Information
PDF template
A form authorizing East Texas Lighthouse/Horizon Industries to release or receive confidential health information with specific conditions and limitations.
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DATA PROTECTION CONSENT FORM
PDF template
Customer consent form for data processing and information sharing in compliance with EU General Data Protection Regulation (GDPR)
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Evaluation To Sign Consent Form
PDF template
A structured assessment to determine a patient's capacity to provide informed consent for a medical study or research protocol.
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EVENTACTIVITY REQUEST RISK ASSESSMENT FORM
PDF template
A comprehensive checklist for evaluating potential risks and participants for events or activities at an institution.
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EVENTACTIVITY REQUEST RISK ASSESSMENT FORM
PDF template
A comprehensive form for submitting and assessing potential risks associated with university events and activities
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Ski Area Release Agreement
PDF template
Legal document waiving liability for ski-related activities at Lake Louise Ski Area, covering potential injuries and property damage.
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Waiver Form
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A legal document providing consent and releasing liability for participation in a St. Jude Children's Research Hospital event.
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East Valley Youth Symphony Media Release Form 2024 2025
PDF template
A media release form granting permission to photograph or record musicians during rehearsals and performances for promotional purposes.
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Piercing Consent Release Form
PDF template
Legal document providing informed consent for body piercing procedures, detailing risks and patient acknowledgments.
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Volunteer Management Toolkit Health And Safety Information
PDF template
A comprehensive guide outlining health and safety responsibilities, reporting procedures, and expectations for volunteers in arts organizations.
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Parental Permission For A Minor To Participate In Research
PDF template
A consent form for parents to allow their high school junior to participate in a research study about student opinions on school start times.
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Release Of All Claims
PDF template
Legal release form for participants of a community garden, acknowledging risks and waiving liability for potential accidents or injuries.
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Ri Masterclass Risk Assessment
PDF template
Comprehensive risk assessment document for managing potential risks during a masterclass event involving children at the Royal Institution (Ri)
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MEDICAL BENEFITS SUBSCRIBER CLAIM FORM
PDF template
A comprehensive medical insurance claim form for submitting healthcare reimbursement or coverage information.
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Southwestern Community College District Excursion Liability Release Agreement Form
PDF template
A liability release form for students participating in off-campus activities or field trips sponsored by Southwestern Community College District.
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Primary Care EXERCISE CLINIC REFERRAL
PDF template
A medical referral form for patients seeking exercise physiology services, documenting health conditions and exercise participation eligibility.
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Exercise Waiver And Release Form
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A legal document releasing fitness facilities or trainers from liability for potential injuries during exercise activities.
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Catholic Identity Commitment Agreement
PDF template
Agreement defining the preservation of Catholic identity and ethical guidelines in the transfer of Catholic Medical Center's healthcare facilities to HCA.
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Liability Waiver Form
PDF template
A liability waiver form for exhibitors at conferences or events at the Hyatt Regency Newport, requiring insurance documentation and releasing Hyatt from potential claims.
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Voluntary Resignation Form
PDF template
Official document for employees resigning from their position at North Ogden City, including legal waivers and acknowledgments.
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Exit Interview
PDF template
A legal document outlining the conditions and process for a student under 16-18 years old withdrawing from school before graduation.
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G Adventures Confidential Medical Form
PDF template
A confidential medical form for travelers with pre-existing medical conditions to assess fitness for expedition travel.
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Emergency ResponsePublic Safety Worker Incident Report Form
PDF template
A form for emergency response and public safety workers to document workplace exposure incidents and medical referral details.
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Hazardous Exposure To Blood And Other Body Fluids
PDF template
Guidelines for managing accidental contact with human blood or body fluids in workplace and educational settings, including immediate response steps and responsibilities.
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Exposure Incident Investigation Form
PDF template
A detailed form for documenting and investigating workplace exposure incidents, including route of exposure, materials involved, and prevention recommendations.
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Form B Exposure Incident Report Form
PDF template
A form documenting potential medical exposure incidents for students during clinical training or placement.
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Texas City ISD Extended Leave Request Form
PDF template
A form for employees to request extended leave with medical certification, to be submitted to Human Resources.
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External Collaborator Requisition Form
PDF template
A form for documenting and tracking tissue sample shipments to the Human Tissue Resource Center at the University of Chicago.
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Laser Eye Examination Form
PDF template
Medical form for documenting laser user eye examination and medical history related to laser exposure risks.
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Eye Examination Waiver Form
PDF template
A form allowing parents/guardians to request a waiver for required student vision examinations due to access or financial barriers.
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Eye Examination Waiver Form
PDF template
A form allowing parents/guardians to request a waiver for mandatory student eye examinations due to financial or access barriers.
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Eye Examination Waiver Form
PDF template
A form for parents or guardians to request a waiver from required eye examination requirements for students in Illinois.
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EyePAC Contribution Form
PDF template
A voluntary contribution form for supporting ophthalmic surgeons' political interests through eyePAC membership tiers.
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CCP Prior Authorization Request Form
PDF template
A form for healthcare providers to submit prior authorization requests for medical services or treatments through Texas Medicaid Health and Human Services.
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LEAP Testing Service Sample Submission Form
PDF template
A form for submitting test samples to LEAP Testing Service for various scientific and medical testing purposes.
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Consent For Sterilization Completion Instructions
PDF template
Detailed instructions for completing a mandatory consent form for sterilization procedures under Wisconsin's ForwardHealth program.
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Consent To Provide Limited Personal Information About Highly Qualified Personnel (HQP) To NSERC
PDF template
A form for obtaining consent from supervised personnel to share limited personal information with NSERC for assessment purposes.
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Donor Consent Form
PDF template
A legal form authorizing whole-body donation for medical research and educational purposes without monetary compensation.
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Texas Immunization Registry (ImmTrac2) Adult Consent Form
PDF template
Consent form for registering immunization records in the Texas Immunization Registry, allowing authorized entities to access vaccination history.
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Form 15080
PDF template
IRS form allowing consent for tax return information sharing with VITA/TCE tax preparation sites.
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All Of Us Research Program Sample Consent Form
PDF template
A consent form for participating in a large-scale health research program funded by the U.S. government to collect health data from 1 million participants.
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WAIVER FORM REQUEST FOR SEPARATION RECORDS
PDF template
A form authorizing the release of law enforcement employment separation records to a prospective employer or the officer themselves.
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F245 145 000 Travel Reimbursement Request
PDF template
A form for workers to request travel expense reimbursement related to workers' compensation medical visits, treatments, or vocational services.
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Puget Sound Benefits Trust Short Term Disability Claim Form
PDF template
A comprehensive form for employees to file a short-term disability claim, requiring details from the employee, employer, and attending physician.
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Form 2624 Consent For Third Party Contact
PDF template
A form allowing taxpayers to authorize the IRS to contact a third party regarding tax information or to revoke such authorization.
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Medical Dental Vision Prescription Weekly Disability Claim Form
PDF template
Comprehensive claim form for medical, dental, vision, prescription, and weekly disability benefits for NW Plumbers & Pipefitters Health Fund members.
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Comprehensive Medical Examination Checklist
PDF template
A medical examination checklist for pilots seeking to operate small aircraft under BasicMed regulations in lieu of a third-class FAA medical certificate.
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Contract Intelligence
PDF template
An advanced AI system for automated, high-precision extraction of key information from complex contracts using neuroscience-based technology.
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Spectra Undergraduate Research Journal Faculty Advisor Agreement
PDF template
A form for faculty mentors to provide consent and verification for undergraduate student research publication.
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Background Check Consent Form For Academic Hires
PDF template
A consent form authorizing Indiana University to conduct a background check as part of the hiring process for academic positions.
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Domestic Academic Student Travel Waiver Form
PDF template
A legal waiver document for students participating in academic field trips or off-campus activities, outlining risk assumptions, medical consent, and vehicle use conditions.
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FACULTY LEAVE AND CLINIC CANCELLATION FORM
PDF template
A form for faculty members to request leave, vacation, or clinic cancellations in the Division of Endocrinology and Metabolism.
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Faculty Leave And Clinic Cancellation Form
PDF template
A form for faculty members to request leave, cancel clinics, and arrange coverage in the Division of Endocrinology and Metabolism.
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UNIVERSITY OF PUGET SOUND FACULTY LEAVE REQUEST FORM
PDF template
A comprehensive form for faculty members to request various types of leave, including medical, family, parental, and extended leaves.
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FAFSA Or DREAM ACT APPLICATION WAIVER FORM
PDF template
A form allowing students to opt out of filing FAFSA or DREAM Act financial aid applications while acknowledging their understanding of the applications.
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Permission To Contact Form
PDF template
Consent form for referral to Families First services in Essex County, focusing on youth and family support.
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Employee Medical Or Family Leave Of Absence Request Form
PDF template
A form for employees to request medical or family leave, indicating type and reason for absence
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Family And Medical Leave Request Form
PDF template
A comprehensive form for employees to request unpaid family and medical leave under federal FMLA guidelines, detailing leave entitlements and notice requirements.
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Family And Medical Leave (FML) Reference Chart
PDF template
Comprehensive reference guide for family and medical leave policies covering federal and California leave regulations for employees.
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Family Camp Medical Form
PDF template
Medical form for capturing health details and emergency contact information for families attending a camp
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Home Office Consent For Verification Form
PDF template
A consent form allowing the Home Office to verify application information and documentation from the applicant and third parties.
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Family Contact Form
PDF template
Form for collecting comprehensive contact and insurance details for a client's family members and guardians.
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Family Emergency Plan
PDF template
A comprehensive document for recording family medical details, emergency contacts, and critical health information for emergency preparedness.
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NECAIBEW Family Medical Care Plan Family Enrollment Form
PDF template
An enrollment form for employees to enroll in the NECA/IBEW Family Medical Care Plan, including personal, spousal, and dependent information.
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Family Medical History Form
PDF template
A comprehensive form for documenting family medical history across multiple health conditions and genetic risks.
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Family Or Medical Leave Request Form
PDF template
A form for employees to request medical or family leave, including documentation of leave type and duration.
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New Medical Form Consent Form FAQ
PDF template
Explanation of changes to Special Olympics Illinois medical documentation requirements including new Medical Form and Consent Form procedures.
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FARM ANIMAL SUBMISSION FORM
PDF template
A veterinary form for submitting farm animal diagnostic and health information for various species and clinical conditions.
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Granor Farm Camp MEDIA RELEASE FORM
PDF template
A consent form authorizing Granor Farm to use participant images and recordings for promotional and educational purposes.
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Nottingham Farm Pathology Submission Form
PDF template
A comprehensive veterinary form for documenting clinical history, animal details, and pathological sample submission for farm animals.
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42314 Webinar Fast Track Medicaid For SNAP Participants Submitted QA
PDF template
A document providing questions and answers about Medicaid enrollment options for SNAP participants across different states.
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Courier Delivery Form
PDF template
A form for authorizing courier delivery of FAVN reports from the Kansas State University Rabies Laboratory with payment options.
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FAVN Report
PDF template
A veterinary form for submitting and reporting rabies antibody titer tests for animal export purposes.
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FAVN Submission Form
PDF template
A form for submitting rabies serum samples for foreign animal vaccine neutralization (FAVN) testing for animal export purposes.
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Voluntary Waiver Form
PDF template
A form for requesting a reduced Facilities and Administrative (F&A) cost rate for research proposals at UNTHSC.
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WRITTEN CONSENT FOR RELEASE OF PERSONAL INFORMATION
PDF template
A form authorizing the Nebraska Department of Motor Vehicles to release specific personal records via fax to a designated recipient.
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FAX REFERRAL FORM
PDF template
A medical referral form for patients seeking low vision rehabilitation services in Colorado.
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Urogynecology New Patient Intake Form
PDF template
Comprehensive medical intake form for urogynecology patients to document urinary and bowel symptoms, medical history, and patient goals.
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Employee Voluntary Waiver Form
PDF template
A form allowing employees to voluntarily waive employer health care expenditures if they receive health coverage through another employer.
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INCLUSA CLAIM FORM
PDF template
A claim form for submitting healthcare service claims to Inclusa Family Care through WPS Health Insurance.
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BioDynamic Manual Therapy, LLC Patient Questionnaire
PDF template
Comprehensive medical intake form for collecting patient health history, current symptoms, and personal health details
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Job Applicant Drug Testing Consent Form
PDF template
Consent form for drug testing as part of job application process for the Department of Juvenile Justice in Florida.
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FD Written Approval For Burn, V.1 42019
PDF template
A form that provides fire department approval for landowners to conduct open burns during otherwise prohibited hours in Ohio.
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Federal And University Guidelines For Protection Of Human Subjects Involved In Research (IRB Applica
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Guidelines for protecting human subjects in research, including IRB review procedures, informed consent requirements, and research definitions.
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Example Of Fellowship Application Form
PDF template
A comprehensive application form for fellowship candidates in preventive cardiology or related medical disciplines.
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MSKCCWeill Cornell Procedural Dermatology Fellowship Application
PDF template
Application form for fellowship in Procedural Dermatology at Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical Center.
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MSKCCWeill Cornell Procedural Dermatology Fellowship Application
PDF template
Application form for a procedural dermatology fellowship at Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine.
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CIRSE Fellowship Information And Application
PDF template
Comprehensive guidelines for physicians and scientists seeking CIRSE Fellowship status in interventional radiology and cardiovascular imaging.
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Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for pathology fellowship candidates covering personal details, education, and fellowship preferences.
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Patient Intake Form
PDF template
Comprehensive intake form for collecting patient personal, contact, and medical background information with emphasis on privacy and demographic details.
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Health Benefits Claim Form
PDF template
A comprehensive form for submitting health insurance benefits claims, including patient and insurance information.
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FERPA CONSENT FORM
PDF template
A form allowing students to consent to disclosure of educational records under the Family Educational Rights and Privacy Act (FERPA)
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Consent To Ongoing Release Of Student Information Under FERPA
PDF template
A form allowing students to authorize release of their academic records to specified individuals or entities under FERPA guidelines.
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FERPA Prior Consent Form For Meetings
PDF template
A form allowing students to consent to disclosure of their educational records for specific meetings at The University of Toledo.
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AUTHORIZATION OF DISCLOSURE CONSENT FORM
PDF template
A form allowing a student to authorize the release of their personal records to specified individuals or departments
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One Time Guest Consent Form
PDF template
A consent form allowing students to authorize UVU employees to discuss their educational records with specified guests during a single interaction.
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Financial Aid And Billing Information Release Authorization Form
PDF template
A form allowing Rensselaer Polytechnic Institute students to authorize release of their financial aid and billing information to designated individuals.
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Reference Request Consent Form
PDF template
A form allowing students to authorize references for employment, educational admission, scholarships, or other purposes with specified consent parameters.
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Student Consent For Release Of Information
PDF template
A form allowing students to authorize or withdraw consent for third parties to access their educational records at California State University, Sacramento.
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FERPA Waiver Form
PDF template
A form allowing students to grant access to their academic records to specified individuals at West Virginia University at Parkersburg.
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FERPA Waiver Form
PDF template
A document allowing students to consent to sharing their educational records during academic advising sessions and waive FERPA privacy rights.
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Nebraska FFA Association Medical Release Form
PDF template
A comprehensive medical consent and emergency contact form for FFA members, allowing parental consent for medical treatment and providing essential health information.
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Feline Friends Service Request Form
PDF template
Form for requesting veterinary and rescue services for cats, used by trappers, fosters, caretakers, and owners.
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ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
A comprehensive legal document that releases liability for participants in various group activities and events.
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FHNO Indus Institutional Fellowship (FIIF) Application Form 2024
PDF template
Application form for medical professionals seeking to apply for the FHNO Indus Institutional Fellowship for the 2024 batch.
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Fora Health Residential Referral Form
PDF template
Comprehensive referral form for admitting patients into Fora Health's residential treatment program with detailed guidelines and requirements.
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Preparticipation Physical Evaluation Medical History Form
PDF template
Comprehensive medical history form for students participating in sports, requiring detailed health information and medical evaluation
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Medical History Form
PDF template
Comprehensive medical history and health screening form for student-athletes to assess fitness for sports participation
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Student Health Insurance Waiver Form
PDF template
Form for students to request a waiver from the university's mandatory student health insurance plan by proving alternative health coverage.
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Release Of Liability, Waiver Of Right To Sue, Assumption Of Risk And Agreement To Pay Claims
PDF template
A legal document that releases California State University from liability for potential injuries or damages during an activity or event.
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Release Of Liability, Waiver Of Claims, Express Assumption Of Risks, And Hold Harmless Agreement
PDF template
Legal document releasing Florida Atlantic University from liability for potential risks and damages during a field trip.
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FIELD TRIPTRANSPORTATION PERMISSION AND WAIVER FORM
PDF template
A legal document granting permission for student participation in a field trip while releasing the school from potential liability.
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Adult Tuberculosis (TB) Risk Assessment Questionnaire
PDF template
A medical screening form for assessing tuberculosis risk in adults, required by California Education and Health Codes.
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Media Release Form
PDF template
A document allowing parents to grant or deny permission for their child to be photographed, videotaped, or interviewed during school events.
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YMCA Camp Independence 2024 Health History And Examination Form
PDF template
Medical form for collecting camper health information and emergency contact details for YMCA summer camp participation.
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Written Consent Form Commercial Co Venturer And Charitable Organization
PDF template
A legal form documenting consent and details for a commercial co-venturer conducting a charitable sales promotion in Hawaii.
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Confidentiality Policy And Consent For Therapy And Assessment Services Agreement
PDF template
A comprehensive policy document detailing therapy services, patient rights, and confidentiality guidelines for a community healthcare clinic.
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Patient Demographics Form
PDF template
Comprehensive medical intake form collecting patient personal, contact, insurance, and consent information for healthcare services.
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Parental Consent And Waiver Form For Minor Students
PDF template
A consent form for parents/guardians allowing minor students (17 or younger) to enroll in Lone Star College courses with specific terms and conditions.
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Enrollment Form
PDF template
Comprehensive form for enrolling a child in childcare, collecting personal information, emergency contacts, and health details.
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InternExtern Application Packet
PDF template
Application for internship and externship opportunities at Elica Health Centers, focusing on medical, dental, and behavioral health fields.
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Humboldt County Referral Initiative Referral Form
PDF template
A comprehensive medical referral form for transferring patient information between healthcare providers with multiple referral type options.
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Focus Group Consent Release Form
PDF template
Consent form for children to participate in a Title V needs assessment focus group conducted by the Pennsylvania Department of Health.
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Consent Form
PDF template
Authorization for Rockaway Development and Revitalization Corporation to obtain personal financial information for credit counseling services.
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Volunteer Orientation
PDF template
A comprehensive orientation document for college students interested in volunteering at a physical therapy clinic to gain healthcare experience and learn about the profession.
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Volunteer Indemnity Agreement
PDF template
Legal document indemnifying Bay Cliff Health Camp against liability for volunteer injuries or losses during camp activities.
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Patient Medical History And Symptoms Form
PDF template
A detailed medical intake form capturing patient demographics, ethnicity, race, symptoms, and previous diagnostic studies and treatments.
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Official LFCS Media Release Form
PDF template
A consent form allowing Lutheran Family and Children's Services to use an individual's image, voice, words, or story for publicity and other purposes.
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Medical Report Health Statement And Immunizations For 2023 2024
PDF template
Medical form for documenting student health status and required immunizations for St. Paul's School enrollment
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Medical Freeze Request Form
PDF template
A form for requesting a temporary freeze on a membership due to medical reasons with specific conditions and documentation requirements.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for capturing patient health information, medical conditions, lifestyle factors, and current health concerns.
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Medical Information Form
PDF template
A comprehensive medical form for students to provide health information, medication details, and parental consent for school medical procedures.
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2024 25 PermissionWaiver Emergency Information Form Minor
PDF template
A comprehensive form for minor participants to provide emergency contact information and release liability for church activities
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NEW CLIENT INFORMATION PAYMENT AGREEMENT
PDF template
A veterinary hospital intake form for new clients to provide personal and pet information along with payment terms.
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New Patient Intake Form
PDF template
Comprehensive intake form for new patients seeking cosmetic procedures, collecting personal information and medical history.
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Osteopathy Patient Intake Form
PDF template
Comprehensive medical intake form for osteopathic patient assessment and medical history documentation.
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OVER THE COUNTER MEDICATION CONSENT FORM
PDF template
A consent form for parents/guardians to authorize over-the-counter medication administration for students at school.
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Patient Information For Appointment Booking
PDF template
A comprehensive patient intake form for medical appointment booking at Peninsula Gastroenterology, collecting personal and medical contact details.
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PATIENT REFERRAL FORM
PDF template
A comprehensive form for referring veterinary patients to specialized veterinary services and departments.
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Patient Registration Form
PDF template
Comprehensive medical intake form for collecting patient personal information, emergency contact details, insurance information, and health history.
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Pharmacy Payment Plan Agreement
PDF template
Payment agreement form for managing pharmacy account balances and establishing payment schedules for outstanding medical charges.
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Arizona JKA 2024 Summer Payson Camp Waiver Form
PDF template
Legal document releasing liability for participation in martial arts training and activities, acknowledging inherent risks of physical injury.
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PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting patient health history, contact information, and medical background details.
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Patient Discharge Form
PDF template
A standardized form for documenting patient discharge details, treatment status, and medical recommendations.
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Consent To Publish PicturesTestimonialsRecordingsVideo
PDF template
Legal document granting Algoma University permission to use participant's images, recordings, and testimonials for promotional purposes.
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PRESCRIPTION MEDICATION CONSENT FORM
PDF template
A form for authorizing prescription medication administration for students, either by school personnel or self-administered.
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Santee Recreation Registration Form
PDF template
Registration form for participants to sign up for recreation activities in the City of Santee, including personal and medical information.
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Sports Participant Waiver Form
PDF template
Legal waiver for participants in sports activities, releasing the organization from liability for potential injuries or damages.
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Summer Camp Registration And Waiver Form
PDF template
Waiver and release form for participants in Colorado Mesa University Tech summer camp program, acknowledging risks and releasing liability.
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Sexual Violence Prevention And Support Centre Service Agreement Informed Consent Form
PDF template
A service agreement outlining support services for students, staff, and faculty who have experienced sexual violence or related challenges at the University of Toronto.
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Immunization Consent Form
PDF template
A comprehensive form for collecting patient demographic, insurance, and consent information for immunization services.
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Waiver Form
PDF template
A liability waiver form for user groups utilizing School District No. 5 (Southeast Kootenay) properties and facilities.
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CLARK COUNTY SCHOOL DISTRICT VOLUNTEER WAIVER AND RELEASE
PDF template
Legal document releasing Clark County School District from liability for volunteer activities and potential risks during service.
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Comments Of National Consumer Law Center Et Al. Regarding TCPA Rules
PDF template
Public comments submitted to the FCC regarding robocall regulations and consumer consent revocation rules under the Telephone Consumer Protection Act.
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TELEMEDICINE INFORMED CONSENT FORM
PDF template
A consent form for students participating in telemedicine services, outlining rights, risks, and understanding of remote healthcare delivery.
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Healthcare Forms Catalog
PDF template
Comprehensive list of medical forms and clinical documentation used across various healthcare departments and specialties.
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Paths To Health NM Tools For Healthier Living Referral Form
PDF template
A referral form for participants to join Paths to Health NM health programs with provider contact information.
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SDGR Membership Declaration
PDF template
Official membership declaration and consent form for members of the Salisbury Diocesan Guild of Ringers, including safeguarding and data protection agreements.
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Financial Assistance Application Form
PDF template
A confidential form for patients seeking financial assistance, requiring detailed personal and income information for healthcare services.
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Financial Assistance Evaluation
PDF template
Application form to help patients determine eligibility for free or discounted healthcare services and public assistance programs.
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Suburban Urologic Associates Financial Policy
PDF template
Detailed financial policy outlining insurance, payment, and billing procedures for a urology medical practice.
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Type 2 Diabetes Risk Assessment Form
PDF template
A comprehensive questionnaire to assess an individual's risk of developing type 2 diabetes within the next 10 years.
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ENGINEERING FIRE RISK ASSESSMENT (FORM 24309)
PDF template
A comprehensive document for assessing fire risk across multiple environmental and geographical factors.
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First Book Liability And Media Release Form
PDF template
A legal document providing liability waiver and media release for participants in First Book events, particularly for minors.
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First Time Appointment Billing Form
PDF template
A billing form for documenting client details, service type, and appointment information for a first-time healthcare consultation.
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Fitness Center Use Agreement And Release Of Liability
PDF template
Legal document outlining liability release and risk assumption for using a fitness center facility in Walnut Creek, California.
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Fitness Studio Membership Form
PDF template
A membership form for joining the Wood Dale Park District Fitness Studio with membership options and liability waiver.
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Standard Immunization Requirements For Admission To U.S. Schools
PDF template
A comprehensive medical form documenting vaccination history and requirements for students entering U.S. schools or programs
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MEDICAL FLEX REIMBURSEMENT FORM
PDF template
A form for employees to request reimbursement for medical and dental expenses through a flexible spending account program.
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Field Level Hazard Assessment Form
PDF template
A comprehensive form for identifying and evaluating potential workplace safety hazards across physical, ergonomic, chemical, and biological risk categories.
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MINORS ONLY FLOWRIDER ARBITRATION AGREEMENT
PDF template
Legal document outlining risks and arbitration terms for minors participating in the FlowRider water amusement ride.
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FLUOROSCOPY AND INTERVENTIONAL REQUISITION
PDF template
Comprehensive form for requesting medical imaging procedures, capturing patient details, medical history, and clinical information.
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Flu Vaccine Form
PDF template
A comprehensive form for patient consent and medical screening prior to receiving a flu vaccine.
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Informed Consent To Body Pierce
PDF template
Legal form for obtaining patient consent and documentation for body piercing procedures in Wisconsin.
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Informed Consent To Tattoo Procedure
PDF template
A legal form for documenting informed consent and required patron information before receiving a tattoo procedure in Wisconsin.
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TEST REQUISITION FORM
PDF template
Medical test requisition form for transplant patient diagnostic testing with comprehensive patient and billing information collection.
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Hospital Discharge Plan For Tuberculosis Patients
PDF template
Comprehensive discharge planning document for patients being treated for tuberculosis, including medical details and follow-up instructions.
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FMLA Leave Request Form
PDF template
A form for employees to request Family and Medical Leave Act (FMLA) leave, outlining eligibility requirements and leave types.
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Requisition For Laboratory Supplies
PDF template
A form for requesting laboratory media, collection kits, supplies, laboratory forms, and reagents from Sacramento County Public Health Laboratory.
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Employee FMLA Leave Request
PDF template
Form for employees to request job-protected leave under the Family and Medical Leave Act (FMLA) for various family and medical reasons.
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FMLA LEAVE REQUEST FORM
PDF template
A comprehensive form for employees to request leave under the Family and Medical Leave Act for various personal and family medical situations.
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FMLA Leave Request Form
PDF template
A form for Harnett County employees to request Family and Medical Leave Act (FMLA) protected leave for various qualifying reasons.
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Family And Medical Leave Request
PDF template
Employee form for requesting job-protected medical or family leave under the Family and Medical Leave Act (FMLA)
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FAMILY OR MEDICAL LEAVE REQUEST FORM
PDF template
A form for employees to request family or medical leave for various personal and family health-related reasons.
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FMLA LEAVE REQUEST FORM
PDF template
A form for employees to request leave under the Family and Medical Leave Act for various personal and family health-related reasons.
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HR FMLAOFLA Leave Request
PDF template
A comprehensive form for employees to request leave under Family and Medical Leave Act (FMLA) and Oregon Family Leave Act (OFLA)
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Family And Medical Leave (FML)Paid Parental Leave (PPL) Request Form
PDF template
A form for employees to request family and medical leave or paid parental leave, including various qualifying reasons for absence.
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Family And Medical Leave Request
PDF template
Request form for employees seeking job-protected leave under the Family and Medical Leave Act (FMLA) for medical or family reasons.
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FARTHEST NORTH PICKLEBALL CLUB MEMBERSHIP FORM
PDF template
Membership registration form for the Farthest North Pickleball Club with liability waiver and annual dues information.
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JANDAKOT AIRPORT HOLDINGS HAZARD REPORT FORM
PDF template
A form for reporting safety hazards and potential risks at Jandakot Airport, used by tenants, employees, and visitors to document safety concerns.
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JANDAKOT AIRPORT HOLDINGS HAZARD REPORT FORM
PDF template
A form for reporting safety hazards and potential risks at Jandakot Airport, with sections for hazard details and management corrective actions.
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FOOD POLICY WAIVER OF LIABILITY FORM
PDF template
A form for event organizers to acknowledge responsibility for food preparation, safety, and liability when catering non-university events.
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Foot And Mouth Disease Fact Sheet
PDF template
A public health document explaining foot-and-mouth disease, its impact on animals, and potential human transmission.
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NHDP Form 133 Foot Evaluation
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Comprehensive medical form for assessing foot condition, nerve function, sensation, and risk categorization.
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FOOT Medical And Insurance Form
PDF template
Medical and insurance form for participants in the Yale First-Year Outdoor Orientation Trips (FOOT) program, collecting health and emergency contact information.
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Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing St. Vincent de Paul from liability for potential injuries during charity walk/run event
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FORAY CHECK INCHECK OUT FORM
PDF template
Waiver and check-in form for participants in mycological society mushroom forays, capturing participant details and liability release.
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Student Travel Profile General Liability Waiver
PDF template
A comprehensive waiver and medical procedure document for students participating in a mission trip, covering liability release and medical emergency protocols.
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International Travel Waiver Form
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A consent form allowing parent/guardian permission for a minor to participate in an international travel event, including liability release and emergency medical consent.
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Foresight Carrier Screen Requisition Form
PDF template
A medical form for requesting genetic carrier screening, collecting patient and clinic information, and processing billing details.
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Pet Agreement
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A legal document outlining terms and conditions for keeping a pet in a rental property, including pet details and owner responsibilities.
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LASER DEVICE REGISTRATION FORM
PDF template
Official form for registering laser devices with the Florida Department of Health Bureau of Radiation Control.
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NEW PATIENT INSURANCE AND OFFICE POLICIES CONSENT FORM
PDF template
A comprehensive form for collecting patient personal, insurance, and medical history information for dental office registration.
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2024 25 On Campus Housing And Dining Contract Waiver Form
PDF template
A form for Iowa State University students to request a housing contract waiver for academic programs outside Ames.
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Form 245b (I) British Skydiving Display Risk Assessment Form
PDF template
A comprehensive risk assessment form for evaluating safety and potential hazards in skydiving display activities.
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Johnson Wales University Health Services Requirements
PDF template
Comprehensive health documentation and vaccination requirements for new students enrolling at Johnson & Wales University
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Form 350 Emergency Medical Service Provider Exposure Report Form
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A form to document exposure to blood and body fluids for emergency medical service providers, tracking details of potential occupational health incidents.
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Background Security Clearance Civilian Employees And Volunteers
PDF template
A comprehensive background check authorization form for civilian employees and volunteers seeking to work with the Delta Police Department.
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HFM Study Form 607 Mailing Blood To NIDDK DNA Repository Form
PDF template
A form for mailing blood samples to the NIDDK DNA Repository with specific shipping and tracking instructions.
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Form 6.4.2.2 Rev. D Service Request Form
PDF template
A form for submitting medical devices for service or repair, requiring verification of decontamination and cleaning.
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Adult Recreation Programs Release, Indemnification Medical Form
PDF template
Legal release and assumption of risk form for adult participants in Bainbridge Island Metropolitan Park & Recreation District programs.
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UAB Department Of Obstetrics And Gynecology Presentation Evaluation Form
PDF template
A form for evaluating the effectiveness of presentations within the UAB Obstetrics and Gynecology department.
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Medical Claim Form
PDF template
A comprehensive form for submitting medical claims and patient information to Anthem Blue Cross and Blue Shield insurance plan.
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OBGYN Formative Feedback Form
PDF template
A comprehensive evaluation form for tracking medical student performance in OBGYN clinical rotation, covering multiple professional and clinical competencies.
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Health Exam Form B
PDF template
A medical form for student athletes to obtain health clearance for participation in school athletic activities in Utah.
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Credit Card Pre Authorization ACH Pre Authorization Form
PDF template
A form allowing patients to pre-authorize credit card or bank account charges for medical services and outstanding balances.
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Medical ControlPhysician Contact Hour Attendance Form
PDF template
Tracking form for medical personnel to document attendance and details of training sessions for emergency medical services.
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Criminal Background Check Consent Form For Applicants
PDF template
Consent form allowing Connors State College to conduct criminal background checks for employment or volunteer opportunities.
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Form C Student Waiver Form
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A legal document outlining conditions and medical treatment provisions for students performing services at Rutgers University.
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FORM D 1 PARENTGUARDIAN PERMISSION SLIP FOR STUDENT TO BE TRANSPORTED BY A PRIVATE VEHICLE
PDF template
Legal form granting parental permission for a student to be transported in a private vehicle by a diocesan-approved driver.
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Informed Risk Insurance Form For Allied Health Students
PDF template
A form documenting student awareness of potential infectious disease risks in clinical settings and insurance requirements for Allied Health students.
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FMLA LEAVE REQUEST FORM
PDF template
A form for employees to request family or medical leave, documenting leave details and employee information.
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Form I 690 Instructions
PDF template
Instructions for immigrants seeking a waiver of certain inadmissibility grounds from U.S. Citizenship and Immigration Services.
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Physical Examination Form
PDF template
Medical form for students at American School of Warsaw to document health status and medical clearance for school attendance and sports participation.
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FORM K FIELD TRIP LIABILITY WAIVER FOR ADULTS
PDF template
Legal waiver form for adult participants on field trips, releasing liability for the diocese and associated organizations.
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Medical History Form
PDF template
Required medical history form for students living on campus or participating in sports, documenting health conditions and physical readiness.
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Nebraska FBLA Medical Release Form
PDF template
A medical release and emergency contact form for Future Business Leaders of America (FBLA) chapter members during events or activities.
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Nebraska FBLA Medical Release Form
PDF template
Medical consent and emergency information form for FBLA chapter members, providing authorization for medical treatment and contact details.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting new patient personal, contact, and demographic information for healthcare providers.
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Physical Examination
PDF template
A comprehensive medical examination form for girls participating in multi-day trips, documenting health status and medical clearance.
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Patient Registration
PDF template
A comprehensive medical patient registration form for collecting personal, contact, and insurance information for a dental practice.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal and health information prior to medical treatment.
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Financial Agreement Appointment Reminders
PDF template
A comprehensive financial agreement outlining patient payment responsibilities, insurance billing, and appointment policies for counseling services.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal and health information for medical treatment purposes.
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OBSTETRICAL Service Request Form
PDF template
Medical service request and authorization form for obstetrical services, used for processing healthcare claims and approvals
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Health Care Personnel (HCP) Baseline Individual TB Risk Assessment
PDF template
A screening form to evaluate tuberculosis risk factors for healthcare personnel
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PRESCRIPTION ORDER FORM
PDF template
A form for obtaining physician authorization for reimbursement of healthcare products and services requiring medical prescription.
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Transfer Request Form
PDF template
A form for requesting transfer of patient medical records to a new healthcare provider or facility.
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Hoxworth Blood Center Donor Consent Form
PDF template
Consent form for student blood donors requiring parental permission and acknowledgment of donation procedures.
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Health Care Program For Children In Foster Care (HCPCFC) Foster Care Medical (Specialty) Contact For
PDF template
A form for healthcare providers to document medical services and assessments for children in the foster care system.
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Contribution Form
PDF template
A charitable donation form for contributing to various healthcare-related funds and programs at Stormont Vail Foundation.
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Laboratory Requisition Form
PDF template
A comprehensive laboratory form for collecting patient blood samples and requesting various medical tests.
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Faith Pharmacy New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Faith Pharmacy, collecting personal, insurance, and medical information.
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Notice Of Hearing And Waiver Form
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A legal document for notifying parents and children of a juvenile court hearing and obtaining their consent for service of notice.
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FPU 4.004 Procedure For Payment, Waiver And Refund Of Tuition, Fees, Fines, And Penalties
PDF template
Policy governing tuition assessment, registration periods, and late registration fee waivers at Florida Polytechnic University.
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PATIENT INTAKE FORM
PDF template
Comprehensive medical history and current health status form for patient therapy intake and medical assessment.
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FRAUD RISK ASSESSMENT FORM
PDF template
A comprehensive form for identifying, assessing, and managing potential fraud risks within an organization.
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PhotoVideo Media Release Form
PDF template
A legal document granting permission for the university to use an individual's photographs, videos, and personal likeness for promotional and educational purposes.
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Free Medical Clinic Volunteer Application
PDF template
Application form for volunteers interested in working at a free medical clinic, requiring background checks and professional license verification.
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Resident FreshmanSophomore Parking Waiver
PDF template
A form for freshman and sophomore students to request a parking waiver at Hampton University based on specific circumstances.
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Inmate Medication Information Form
PDF template
A comprehensive medical form capturing medication history, psychiatric treatment details, and contact information for incarcerated individuals.
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NEW PATIENT INTAKE FORM
PDF template
A comprehensive form for new pharmacy patients to provide contact, medical, and medication preferences.
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Volunteer Form Release Of Claims
PDF template
Legal release form for volunteers participating in activities with Friends of the Blue Ridge Parkway, covering volunteer responsibilities and liability waivers.
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Consent For COVID 19 Immunization
PDF template
A consent form for COVID-19 immunization at Alberta Health Services, to be used when a parent or alternate decision-maker cannot be present with the person being immunized.
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Amprion Clinical Laboratory Test Requisition Form
PDF template
Laboratory test request form for collecting patient information, test details, and diagnostic information for Amprion Clinical Laboratory.
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Amprion Clinical Laboratory Test Requisition Form
PDF template
Medical laboratory test request form for collecting patient, billing, and diagnostic information for laboratory testing.
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Medical Reimbursement Form
PDF template
A comprehensive checklist for submitting medical reimbursement claims to Mass General Brigham Health Plan, detailing required documentation and submission process.
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Incident Report Form
PDF template
A comprehensive form used to report serious incidents, breaches, injuries, or emergencies within an organization or chapter.
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Veterinary Diagnostic Center General Submission Form
PDF template
A comprehensive form for submitting veterinary diagnostic specimens and animal health information for analysis and testing.
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Consent Form
PDF template
Legal consent document for authors to grant publication rights and acknowledge privacy implications of manuscript publication.
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EMS DUTY OFFICER Provider Feedback Form
PDF template
A form used by Montgomery County Fire and Rescue Services to document and evaluate emergency medical service provider performance and incident details.
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Health And Dependent Day Care Reimbursement Form
PDF template
Form for submitting health care and dependent day care expense claims under a Section 125 Cafeteria Plan for reimbursement.
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Text, E Booking E Mail Consent Form
PDF template
Patient consent form outlining risks and conditions for electronic communication with healthcare providers.
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Fraser Street Medical Clinic New Patient Registration Form
PDF template
Comprehensive medical intake form for new patients collecting personal information, medical history, and current health symptoms.
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Media Release Authorization
PDF template
A media release form authorizing Frisco Symphony Orchestras to take and use photographs and recordings of a student participant.
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FAFSA Financial Information Disclosure Form
PDF template
A form allowing students to consent to sharing federal tax information for financial aid purposes with specific entities or individuals.
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CareDx Transplant Test Requisition Form
PDF template
Medical form for ordering transplant-related diagnostic testing with patient and clinical information details
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CareDx Lung Transplant Test Requisition Form
PDF template
Medical form for ordering diagnostic testing for lung transplant patients, used to track patient information and test requirements.
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Discharge Form
PDF template
A comprehensive form for tracking patient discharge details, follow-up care, and medical conditions in a healthcare setting.
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Funeral Home Reimbursement Form
PDF template
Form for reimbursing funeral homes for additional costs associated with preparing and reconstructing organ, tissue, or eye donors for family viewing.
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FUNfitness Media Release Form
PDF template
A consent form allowing photography, video recording, and voice recording for media projects related to physical therapy.
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MEDICAL HISTORY FORM
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Comprehensive form for collecting patient personal information, medical history, and dental visit details
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Pre Authorization Form
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Medical form for patients seeking insurance pre-authorization for hospital treatment, documenting patient and medical details for insurance approval.
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Maryland Statewide Medical Assistance Transport TransferDischarge Form
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A county health department form for documenting medical transportation needs and patient transfer details for medical assistance recipients.
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School Fee Waiver Application
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Application for students to request waiver of school-related fees based on specific eligibility criteria such as income, public assistance, or special circumstances.
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Patient Interview Form
PDF template
Comprehensive medical intake form for collecting patient demographic, health history, and contact information.
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GAANN Fellowship Application Form
PDF template
Application form for GAANN Fellowship at FIU, focused on AI and Cybersecurity research doctoral programs.
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Gannon University Health Examination Form
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A comprehensive health form required for students to access university health services and on-campus housing at Gannon University.
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New Patient Inquiries
PDF template
Comprehensive guide for new patients to register and schedule an appointment with the Geriatric Assessment Program at University of North Texas Health Science Center.
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Initial Operational Risk Assessment Form
PDF template
A comprehensive risk evaluation form for assessing marine mission safety across multiple critical factors.
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Gastrointestinal Order Form
PDF template
A comprehensive medical order form for managing student's gastrointestinal, feeding, suction, catheterization, and ostomy care needs during the school year.
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PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for patients at Gateway ENT to collect personal health information, medical history, and family health background.
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Gateway To Nucala Enrollment Form
PDF template
Enrollment form for healthcare providers to prescribe and administer Nucala medication, including prescriber and clinical information.
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MedicalEmergency Information And Waiver Of Liability And Parental Consent Form
PDF template
A comprehensive medical information and liability waiver form for participants in Great Bay Rowing activities, collecting emergency contact details and medical history.
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GCAA Form 7 Liability Waiver Form
PDF template
A liability waiver form for student athletes participating in GCAA athletic events, requiring parent or guardian signature.
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Authorization Disclosure Of Confidential Information
PDF template
A form authorizing the release of confidential medical information to a specified healthcare facility with patient consent and time-limited authorization.
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Name Based Criminal Background History Record Information ConsentInquiry Form
PDF template
A form authorizing a background check for employment or working with specific populations, collecting personal information and consent for criminal history review.
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Global Counseling Patient Intake Form
PDF template
Comprehensive medical intake form for counseling services, collecting patient personal and insurance information.
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Consent Form
PDF template
A form for individuals to provide consent for communication and data usage by a local council.
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Leominster Allotment Association Data Protection Act 2018 Consent Form
PDF template
Consent form for data protection and communication preferences for the Leominster Allotment Association members.
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Athletic Participation Form KHSAA Form GE04
PDF template
Official form for high school students to obtain parental consent and medical release for athletic participation in Kentucky.
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Media Release Form
PDF template
A form granting permission for the West Virginia Higher Education Policy Commission to use an individual's photographs, videos, and quotations in promotional materials.
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Underage GED Consent Form
PDF template
Consent form for students under 18 to enroll in the GED preparation program, requiring parental/guardian permission and verification.
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GED Test Candidate Rules Agreement And NDA Canada And International (ParentGuardian Consent)
PDF template
A legal agreement outlining rules and consent requirements for GED test candidates under 18 in Canadian and international jurisdictions.
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Florida GED Testing Program Underage Waiver Form
PDF template
Form allowing students aged 16-17 to take the GED exam under specific district school board requirements.
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GEDWorks Program Parental Consent Form
PDF template
Consent form for GED testing candidates outlining test center rules, personal item restrictions, and identification procedures.
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Medical Claim Form
PDF template
Comprehensive guide for completing and submitting medical insurance claims to GEHA, including instructions for in-network and out-of-network claims.
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YMAHE Health Assessment Form
PDF template
Comprehensive health assessment form for first-year students requiring medical history, vaccination records, and physical examination details.
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Minor Athlete General Consent Form
PDF template
A consent form for parents/guardians to authorize individual training sessions, athletic training, and other activities for minor athletes while addressing abuse prevention policies.
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Liability Waiver Form Stained Glass Workshop
PDF template
A legal document outlining safety procedures and liability release for participants in stained glass classes at MOCA and SHill Creations Studio.
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Bridge To Wellness Wellbeing Program General Medical Form
PDF template
A form for employees to document preventative medical, dental, eye, and dermatology examinations for a workplace wellness program.
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WAIVER OF LIABILITY PERMISSION MEDICAL RELEASE FORM
PDF template
A liability waiver and medical release form for students staying overnight in a Mount Holyoke College residence hall, covering medical consent and risk acknowledgment.
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GENERAL REFERRAL FORM
PDF template
A comprehensive medical referral form for scheduling various imaging procedures at Cedars-Sinai Medical Center.
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General Release And Medical Information Form
PDF template
A comprehensive form for youth program participants covering medical information, emergency contacts, and liability release for recreational activities.
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Glenville State University Reasonable Accommodation Medical Verification And Inquiry Form
PDF template
A form for employees to request medical accommodations at Glenville State University, involving medical verification and authorization for information release.
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General Test Request
PDF template
A comprehensive medical test request form used for submitting patient specimens and information to Mayo Clinic Laboratories for diagnostic testing.
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Partners HealthCare System Research Consent Form
PDF template
A comprehensive consent form template for medical research studies detailing participant rights and study participation guidelines.
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General Risk Assessment Form For Coaches And Run Leaders
PDF template
A comprehensive risk assessment document for athletic activities covering potential hazards and mitigation strategies for coaches and athletes.
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Necropsy And Lab Report Distribution Form
PDF template
A form for submitting animal specimens for laboratory testing, necropsy, and diagnostic purposes.
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General Test Requisition
PDF template
A comprehensive medical test requisition form for healthcare providers to submit specimens for laboratory testing, covering various health conditions and tests.
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University Health Report
PDF template
Comprehensive health form for Northeastern University students requiring vaccination documentation and personal health information
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Vaccine Administration Record (VAR)Informed Consent For Vaccination
PDF template
A comprehensive form for collecting patient information and consent for vaccination at Walgreens.
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Medical Release, Photo Release, Liability Waiver Form
PDF template
Comprehensive waiver for participants in a construction training program, covering medical risks, property damage, and legal liability.
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MEDICAL HISTORY AND RELEASE FORM
PDF template
Medical history and consent form for DeMolay participants under 21 years of age, including health history and liability release.
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Physician Referral Form
PDF template
A comprehensive medical referral form for routing patients to various medical specialties at Emory Healthcare.
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Homerton College, Cambridge, Risk Assessment Form
PDF template
A comprehensive risk assessment form for identifying, evaluating, and mitigating potential hazards in workplace or academic activities.
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Gentle Doctor Statue Order Form
PDF template
Order form for purchasing a statue of a doctor from Iowa State University's Veterinary Medicine department.
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Galaxy Explorers Program Participation Consent And Medical Authorization Form
PDF template
A parental consent and medical authorization form for children participating in Chabot Space & Science Center's Galaxy Explorers program, covering activities, field trips, and medical emergencies.
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Patient Intake Form
PDF template
Comprehensive patient intake document for healthcare services, collecting personal, contact, and medical information with insurance and consent provisions.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new chiropractic patients, collecting personal information and detailed health history.
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Laboratory Specimen Collection Form
PDF template
A detailed form for collecting patient and specimen information for laboratory testing and analysis.
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Quartz Medicare Advantage (HMO) Quartz CashCard Reimbursement Form
PDF template
Form for Medicare members to request reimbursement for fitness memberships or medical transportation rides using their Quartz CashCard.
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Dental Claim Form
PDF template
A comprehensive form for submitting dental insurance claims, capturing patient, subscriber, and dental service details.
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Pre Participation Physical Evaluation History Form
PDF template
Official medical evaluation form for student-athletes participating in Georgia high school sports, detailing medical history and physical examination requirements.
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Giant Food Pharmacy Vaccine Informed Consent
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A comprehensive form for collecting patient information, insurance details, and consent for vaccination at Giant Food Pharmacy.
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Background Check Consent Form
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Official form for providing biographical and personal information to authorize a background check investigation.
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Michigan Gastrointestinal Illness Complaint Interview Form
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A comprehensive form for documenting and investigating gastrointestinal illness complaints, patient information, and medical details.
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LSU SVM Gift Contribution Form
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A form for making financial contributions to support various programs and funds at the LSU School of Veterinary Medicine.
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Gift Contribution Form
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A donation form for contributing to various funds within the Virginia Tech College of Veterinary Medicine
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Camper Medical Form
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Medical form for assessing a camper's health status, medical conditions, and fitness for camp participation.
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Health And Medical History Form
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A comprehensive medical history and health information form for American Heritage Girls members, valid for 12 months.
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Girl Scouts Health History And Medical Examination Form For Minors
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Comprehensive medical and health history form for Girl Scout participants to capture essential health information and emergency contact details.
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Health History And Medical Examination Form For Minors
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Comprehensive medical form for collecting health information and medical history for Girl Scouts participants under 18 years old.
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GITREP 4A Waiver Of SellerS Filing Requirement Of GITREP Forms And Payment For Corrected Deed With N
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A state form allowing property owners to record a corrective deed without additional tax filing requirements for typographical or clerical errors.
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City Of Ann Arbor Volunteer Release Waiver Of Liability
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Legal document outlining liability and risk assumptions for City of Ann Arbor volunteers, detailing participant responsibilities and legal protections.
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Gresham Japanese Garden Release, Waiver Of Liability And Indemnity Agreement
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Legal agreement for renting the Gresham Japanese Garden property, outlining risks and liability limitations for renters.
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Short Term Disability Claim Form Statement Of Employee
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A comprehensive form for employees to file a short-term disability claim with detailed personal, employment, and medical information.
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Long Term Disability Claim Form PhysicianS Statement
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A comprehensive medical form for submitting a long-term disability insurance claim, requiring detailed patient and medical information.
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Global Mamas Health Emergency Contact Form
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A comprehensive medical and contact information form for Global Mamas organization, collecting personal details and health history.
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GMAT Waiver Request Form
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A form detailing multiple pathways for qualifying for a GMAT test requirement waiver for graduate program admission.
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Greater Northwoods MLS Waiver Form
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A form for real estate professionals to request waivers for MLS listing requirements related to entry timing, photos, or listing status.
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Rental Agreement Form
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Rental form for airsoft equipment with terms of responsibility and rental details.
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Center For Endocrine Tumors And Disorders Patient Intake Form (Dr Goldfarb)
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Comprehensive medical intake form for patients with endocrine-related health concerns, collecting personal, medical, and medication history.
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Application For Good Cause Waiver
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A state application for individuals seeking a waiver for background screening findings related to employment eligibility.
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Gourmet Dining Supporting Small Businesses Waiver Form
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A document outlining procedures for external catering requests at Seton Hall University, managed by Gourmet Dining Services.
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Great Path Academy 2017 2018 Appearance Release
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Permission form for parents/guardians to authorize or decline use of student photos and work in school publications and marketing materials.
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Waiver Form And Multimedia Release Form
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Legal document for releasing liability and granting/denying media consent for park district program participation.
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GPLN Laboratory Submission Form
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Comprehensive form for submitting laboratory specimens related to poultry and avian health testing and research.
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SOR GPRA Frequently Asked Questions
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Guidance for providers on GPRA data collection requirements for clients receiving SOR-funded treatment.
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Grade Appeal Form
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Form for students to request a review of their academic grade at Washington University School of Medicine.
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FAFSA Waiver Form
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A form allowing students to waive the requirement of completing the Free Application for Federal Student Aid (FAFSA) while acknowledging potential loss of financial aid eligibility.
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Graduation Pathways Postsecondary Readiness Competency Waiver Form
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A form for students who did not complete postsecondary-readiness competencies or transferred schools during senior year to request a waiver for graduation requirements.
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General Outpatient Referral Form
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A medical referral form for patients seeking healthcare services at Grady Health System in Atlanta, Georgia.
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Grant Application Form
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A comprehensive grant application form for funding research and projects at the Mater Hospital Foundation in Dublin, Ireland.
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Grant Application Form
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Comprehensive form for submitting research grant proposals to the International Essential Tremor Foundation (IETF)
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Grateful Patient Contribution Form
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A form for patients to make tax-deductible contributions to support endodontic research, education, and awareness.
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GRMC Foundation Contribution Form
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A tax-deductible donation form for supporting various fundraising categories at Gila Regional Medical Center Foundation.
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Pre Authorisation Form Group Care
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A medical insurance form for requesting cashless hospitalization, to be filled by the patient and treating doctor
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Group International Travel Form
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A form for students and faculty to request and document international travel, required at least 60 days prior to departure.
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Group Short Term Disability Claim Form
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A comprehensive form for filing a short-term disability insurance claim with Dearborn National, capturing employee medical and income details.
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SCENE75 ENTERTAINMENT CENTER ALL VENUE ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
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Legal document releasing Scene75 Entertainment Center from liability for potential accidents or injuries during participation in venue activities.
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Georgia Regents University Volunteer Agreement Form
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A legal document outlining the terms and conditions for volunteers at Georgia Regents University, specifying responsibilities and limitations of volunteer service.
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GSS Waiver
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Legal document releasing UBC Graduate Students Society from liability for potential risks during an event or activity.
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Girl Scouts Health History And Medical Examination Form For Minors
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Comprehensive health history and medical examination form for Girl Scout participants to document medical information and insurance details.
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Guest Medical Information Form
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Confidential medical form for assessing guest fitness and suitability for an Antarctic expedition, collecting comprehensive health history.
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Guidance Obtaining Consent From Subjects With Limited English Proficiency
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Detailed guidance for obtaining informed consent from research subjects with limited English proficiency, covering different interpreter scenarios.
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Guidelines For Acceptable Documentation
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Comprehensive guidelines explaining acceptable documentation for medical and personal circumstances affecting academic course completion.
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Accident Waiver And Release Of Liability
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Legal document waiving liability for participants in a university athletic event involving physical risks and potential injury.
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Pre Award Risk Assessment Form
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A form used to evaluate potential risks associated with sub-grantee funding applications for highway safety grants.
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REIMBURSEMENT FORM
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Form for submitting optical services reimbursement to General Vision Services by members.
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Media Release Form
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A legal document granting permission for the GiveWell Community Foundation to use an individual's image, voice, and personal statements for various purposes.
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Medical History Form
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A comprehensive form for collecting patient medical history, health details, and emergency contact information for dental service purposes.
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COVID 19 CVD Registry Powered By Get With The Guidelines Investigator Initiated Research Proposal Fo
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A form for researchers to submit investigator-initiated research proposals related to the COVID-19 Cardiovascular Disease Registry by the American Heart Association.
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Get With The Guidelines Quality Improvement Research Opportunity
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Request for research proposals focused on intracerebral hemorrhage (ICH) stroke using Get With The Guidelines data collection.
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Permission To Contact For Research
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A form allowing Gulf War veterans to authorize contact for potential research participation in a biorepository brain bank study.
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Reimbursement Request Form
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A form for members to request reimbursement for eligible healthcare services paid out-of-pocket.
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Influenza Sentinel Provider Report Form
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Comprehensive medical reporting form for tracking influenza cases, patient information, clinical data, and laboratory test results.
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PATIENT INTAKE FORM
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Comprehensive form for collecting patient personal, contact, insurance, and medical information for healthcare providers.
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Request For Hospital DischargeTransfer Approval Form (H 804)
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A medical form for documenting tuberculosis patient discharge, medication regimen, and transfer details for healthcare providers.
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2016 Haiti Mission Trip Payroll Deduction Form
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A form for employees of Morehouse School of Medicine to make a financial contribution to a Haiti Mission Trip through payroll deduction or direct payment.
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University Of Toronto Hand Fellowship Application Form
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Application form for medical professionals seeking a hand surgery fellowship at the University of Toronto.
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XAVIER HAP 2024 Personal Health History
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A comprehensive medical history form for students, to be completed by parents or guardians before submitting to a medical provider.
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Hardship Refund Request Form
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Policy detailing conditions and process for students to request tuition refunds due to exceptional medical or family circumstances.
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REQUEST FOR HARDSHIP WAIVER
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A form for individuals seeking an administrative hearing and fee waiver for parking tickets based on financial hardship
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Hawaii HIPAA Authorization For Release Of Information
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A form allowing patients to authorize the release of their personal health information to specified individuals or organizations.
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Registration Form
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Comprehensive registration form for healthcare services, collecting patient demographic, contact, insurance, and medical history information.
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Hazard Identification And Risk Assessment Form
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A comprehensive form for identifying workplace hazards, potential risks, and required safety controls.
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Hazardous Energy Assessment Form
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Comprehensive form for identifying and assessing potential hazardous energy sources in equipment, including types, magnitudes, and control methods.
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Hazard Report Form
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A comprehensive form for documenting and assessing workplace safety hazards and risks.
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HAZARD REPORT FORM
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A standardized form for documenting workplace safety hazards, observations, and recommended corrective actions.
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Hazard Report Form
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A comprehensive form for identifying and assessing workplace safety hazards and potential risks to personnel, environment, and property.
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Hazard Report
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A safety report documenting an ice hazard near an east shop door and recommended corrective actions.
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HAZARD REPORT FORM
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A document for employees to report workplace safety hazards and for management to investigate and resolve potential risks.
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Hazard Report Form
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A comprehensive form for identifying, assessing, and reporting workplace safety hazards with risk assessment matrix.
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HAZARD REPORT FORM
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A comprehensive form for documenting workplace safety hazards, potential risks, and immediate actions taken to mitigate dangers.
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Hazard Risk Assessment Form
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A comprehensive document for identifying, evaluating, and mitigating potential workplace hazards and risks across various environments.
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REQUEST FOR MEDICAL ELIGIBILITY DETERMINATION
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A form for assessing an individual's medical care needs and eligibility for healthcare services or facilities.
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Provider Enrollment Form
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Comprehensive form for healthcare providers to enroll and provide professional details for credentialing and practice information.
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Sample Of Consent Form For The HCBS CAHPS Survey
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A consent form template for a survey about home and community-based services for people with disabilities, designed to gather feedback and improve service quality.
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Radiology Exam Order Form
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A comprehensive form for ordering radiology examinations, collecting patient, provider, and insurance information for medical imaging services.
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1500 Health Insurance Claim Form
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Standard medical claim form used for submitting healthcare insurance reimbursement requests.
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Patient Intake Form
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Comprehensive patient registration form collecting personal, demographic, and healthcare-related information.
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OHSU Referral Form
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A comprehensive medical referral form for patients being referred to various specialty departments at OHSU (Oregon Health & Science University).
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Media Release Form
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A consent form allowing HCOE to photograph, videotape, record, and interview students for educational and informational purposes.
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Health Care Provider Accommodation Assessment Form
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A form for employees to request reasonable workplace accommodations by obtaining medical documentation from their healthcare provider.
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Health Care Provider Examination Form
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A comprehensive healthcare provider form for documenting medical examinations, immunization history, and patient assessments.
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Participant Consent Form (Health Care Providers)
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A consent form for healthcare providers participating in a research study investigating healthcare access challenges for chronic back pain across rural and urban settings in Saskatchewan.
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HCPCS Authorization Form
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Medical form used for requesting authorization for medical procedures or medications with detailed patient, physician, and treatment information.
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Form 4506 Health Care Practitioner Physical Assessment Form
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Medical assessment form for collecting a resident's comprehensive health history and current medical status for assisted living program admission
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Form 4506
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A detailed medical assessment form for evaluating a resident's health status and medical history for assisted living admission.
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Weld HCP Referral Form
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A comprehensive referral form for healthcare coordination and client information collection in Weld County, Colorado.
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ADA Medical Questionnaire
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Medical questionnaire for employees requesting workplace accommodations under the Americans with Disabilities Act (ADA)
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CMS 1500 Claim Filing Instructions
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Detailed guidelines for completing the CMS-1500 healthcare claim form with specific instructions for each field.
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Mandatory Tuberculosis (TB) Risk Assessment Form
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A comprehensive medical form to assess tuberculosis risk factors and required testing for students, particularly those from high-risk regions or with specific exposure history.
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Western Carolina University Base Camp Cullowhee Health And Medical Form
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A health screening form for participants in outdoor activities, collecting medical history and current health status details for safety purposes.
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Sample Allotments Risk Assessment Form
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A comprehensive risk assessment template for identifying and evaluating potential hazards in allotment sites with calculated risk ratings.
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Health And Temperament Agreement
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A legal agreement outlining owner responsibilities and liability waivers for dogs attending a dog daycare facility.
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SUNY State College Of Optometry Health Assessment
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Medical immunization and health screening form for SUNY State College of Optometry credentialing purposes.
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Health Assessment Form For Compliance With K.S.A. 72 5214
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A comprehensive health screening form for children entering school, requiring parental consent and medical provider certification.
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Tips For Claim Submission
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Comprehensive guide for submitting healthcare and flexible spending account claims, detailing documentation requirements and eligible expenses.
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Tips For Claim Submission
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Comprehensive guide for submitting medical expense claims, including eligible expenses, documentation requirements, and over-the-counter medication rules.
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Expense Reimbursement Voucher For Healthcare Flexible Spending Account (Healthcare FSA)Health Reimbu
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A form for employees to request reimbursement for medical expenses through their flexible spending account or health reimbursement arrangement.
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Medical Inquiry Form Accommodation Request
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A medical form for healthcare providers to evaluate an employee's physical or mental impairments and potential workplace accommodations.
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Co PayDeductible Reimbursement Form
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Form for students to request reimbursement for medical co-pays and deductibles, with specific instructions and limitations.
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Health Examination Form (Form 003)
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Comprehensive health examination and immunization requirements form for nursing students entering a clinical program.
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Student Health Services Health Evaluation Form
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Medical form used by students to document health status, current conditions, and activity clearance for university health services.
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Required NYS School Health Examination Form
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Comprehensive health assessment form for students in New York State, documenting medical history and physical examination details.
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CHILDCARE GENERAL HEALTH EXAMINATION FORM
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A health examination form for children enrolling in early education programs to document their medical status and health conditions.
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Certificate Of Child Health Examination
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Official state document for recording child's health examination and immunization records.
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Health Extras Reimbursement Form
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Form for submitting healthcare service reimbursement claims through Independent Health's Health Extras program.
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Health Fee Waiver Form
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A form allowing students to waive health fees based on specific exemption criteria under California Education Code Section 76355.
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HealthFlex Mandatory Premium And Coverage Waiver Form
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A form for employees to decline health insurance coverage and declare reasons for waiving enrollment in the HealthFlex plan.
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Health Form
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Medical health assessment form for participants in wilderness expeditions with Alaska Mountain Guides and Climbing School Inc.
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Girl Scouts Of West Central Florida Health Examination Form
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Comprehensive health form for documenting medical history and emergency contact information for Girl Scouts participants and volunteers.
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Physical Examination Form
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Medical form for documenting a child's physical health status and ability to participate in a child care program.
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Health Records Form
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Comprehensive health documentation required for student enrollment at Bennett College, including immunization records and medical consent forms.
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Medical History Form
PDF template
Comprehensive medical history form for students collecting personal health information, medical conditions, and health maintenance details.
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Medical History Form
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Comprehensive medical history form capturing patient's health status, previous illnesses, and current medical conditions.
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Health History Physical Exam Form
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Confidential medical history form for Allied Health and Nursing students at Minnesota West Community and Technical College to document health status and medical background.
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MEDICAL HISTORY FORM
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Comprehensive medical history form for patient intake, collecting personal health information, medical conditions, and allergies.
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Health Information Form
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Detailed medical history and personal health form for participants, collecting comprehensive health information and emergency contact details.
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Health Insurance New EnrollmentWaiver Form
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A form for AmeriCorps members to enroll in or waive health insurance coverage during their program participation.
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Health Insurance Waiver Form
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A form for Genesee Community College employees to waive their group health insurance plan and provide alternative coverage evidence.
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HEALTH INVENTORY FORM
PDF template
A comprehensive medical history form for collecting student health information, including past diseases, treatments, and current medical status.
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Medical Claim Form
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A comprehensive form for submitting medical insurance claims, capturing patient, subscriber, and medical service details.
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Authorization For Use Or Disclosure Of Protected Health Information
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A confidential form authorizing the disclosure of protected health information by The Episcopal Church Medical Trust
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HealthMedication Authorization Form
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Form for authorizing medication administration for participants in M-NCPPC park and recreation programs, including prescription and non-prescription medications.
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HEALTHPHYSICAL EXAMINATION FORM
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Medical examination form for students enrolling in various healthcare and child care educational programs to assess physical fitness and health status.
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Health Professions Personal Medical History Form
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Medical documentation form for health professions students to submit immunization and health screening records for clinical experiences.
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HEALTH PROFESSIONS STUDENT HEALTH FORM
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Medical documentation form for students in nursing, pharmacy, physician assistant, and dietetic internship programs, requiring immunization history and verification.
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ETA FORM 653 Job Corps Health Questionnaire
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A health assessment form for Job Corps applicants to provide medical information and authorize basic healthcare services
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Health Risk Assessment Form
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A comprehensive form that evaluates an individual's physical health, personal safety, fitness, nutrition, work environment, and social-emotional well-being.
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Health And Safety Student Waiver Form Part A
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COVID-19 safety waiver for students participating in boot camp activities at the Bahamas Technical and Vocational Institute.
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Health Savings Account (HSA) Contribution Form
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A form for depositing funds into a Health Savings Account with instructions for contribution types and participant authorization.
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Physical Examination Form
PDF template
A comprehensive medical examination form required for admission to health science programs at Laredo College.
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Health Services Student Medical Form
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Comprehensive medical form for students enrolling in various healthcare-related programs and continuing education classes at Catawba Valley Community College.
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MCPS Form SRS 6 Student Record Card 6
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A comprehensive health form for students entering Maryland public schools, requiring medical examination and immunization documentation.
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Meningitis And Hepatitis B Immunization Health History Form
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Comprehensive form detailing immunization requirements for students, including MMR, Varicella, and Tuberculosis skin test documentation guidelines.
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School Health Services Health Survey Form
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A comprehensive health information form for students entering school, collecting medical history, contact information, and health service needs.
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Heartland Anglers Membership Form
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Membership registration form for Heartland Anglers fishing tournament participants with liability release and contact information collection.
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STUDENT RECORD CARD SR 6 (Local)
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A mandatory health form for students entering Maryland public schools, documenting physical examinations and immunization requirements.
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NYU Langone Health Information Exchange Consent Form
PDF template
A consent form allowing patients to choose whether NYU Langone Health can access and share medical records through health information exchanges.
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Medical Form
PDF template
Medical history and immunization form for students, requiring detailed health information and parental consent.
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Medical Form
PDF template
Comprehensive medical history and immunization form for students, requiring detailed health information to be completed by parents/guardians and physicians.
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DR. E. BRUCE HENDRICK ONTARIO SCHOLARSHIP PROGRAM 2023 MEDICAL ASSESSMENT FORM
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A medical assessment form for students with spina bifida or hydrocephalus applying for the Dr. E. Bruce Hendrick Ontario Scholarship Program.
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Hepatitis B Vaccine Waiver
PDF template
A document allowing students to opt out of receiving the Hepatitis B vaccine while acknowledging the risks and benefits of immunization.
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Hepatitis B Vaccination Waiver Form
PDF template
Form for students to decline Hepatitis B vaccination while acknowledging potential health risks from occupational exposure.
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NIDDK Hepatology Fellowship Application Form
PDF template
Application form for individuals seeking a hepatology fellowship at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Grade 7 School Immunization Program Consent Form For HB And HPV Vaccines
PDF template
A consent form for Hepatitis B and HPV vaccinations for Grade 7 students, requiring parent/guardian approval and health assessment.
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THREE WAY CONFIDENTIALITY AGREEMENT
PDF template
A multi-party confidentiality agreement for potential research and business collaboration involving exchanging sensitive information.
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Parental Consent Form Highlighting Effective Teaching Strategies (HETS) Project
PDF template
A consent form for parents to allow their child's classroom to be videotaped for a research study on effective teaching strategies in Hawaii schools.
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Release And Waiver Of Liability
PDF template
Legal document releasing Habitat for Humanity from liability for volunteers participating in construction and related activities
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PATIENT FRIENDLY BILLING PATIENT GLOSSARY OF BILLING TERMS
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A comprehensive guide to commonly used financial terms in healthcare billing, designed to improve patient understanding of medical financial communications.
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HFT Sample IRB Consent Form
PDF template
Consent document for using human fetal tissue collected during abortion for research purposes, ensuring voluntary donation without coercion.
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Consent For Total Body Donation
PDF template
A legal form for next of kin to consent to donating a deceased person's body for anatomical study and research.
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NYCHHC HIPAA Authorization To Disclose Health Information
PDF template
A form authorizing the release of personal medical and health information with specific privacy protections and consent requirements.
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Hickory Hill Member Family Emergency Contact Form
PDF template
A form for collecting emergency contact and medical authorization details for club members and their families.
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Texas Health And Human Services Acronym Guide
PDF template
A comprehensive list of acronyms used by Texas Health and Human Services covering various healthcare and administrative terms.
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NCIEC Healthcare Interpreting Fellowship Application Form
PDF template
Application form for healthcare interpreters seeking a professional fellowship program in medical interpreting across multiple US locations.
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Risk Assessment Form
PDF template
A comprehensive risk assessment document for scout hiking activities covering navigation, road safety, and group management.
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HAWAII INSTITUTE OF MARINE BIOLOGY YOUTH WAIVER
PDF template
Waiver form for non-employees, including visitors, interns, volunteers, and researchers under 18 years old visiting the Hawai'i Institute of Marine Biology property.
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Patient Intake Form
PDF template
Comprehensive medical questionnaire collecting patient personal, insurance, and health history information for medical providers.
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FDNY HIPAA AUTHORIZATION TO DISCLOSE HEALTH INFORMATION
PDF template
Form authorizing the release of personal health information with specific consent parameters and privacy protections.
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HIPAA Compliance Patient Consent Form
PDF template
A form detailing patient consent for healthcare information usage, disclosure, and privacy practices under HIPAA regulations.
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Consent To Treat Form Acknowledgement Authorization Of HIPAA Privacy Practices
PDF template
A consent form for patients receiving occupational therapy, outlining treatment authorization and patient rights regarding medical information and procedures.
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Authorization For Release Of Health Information Pursuant To HIPAA
PDF template
Official form allowing patient authorization for release of sensitive medical information in compliance with HIPAA regulations.
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HIPAA Acknowledgement And Medical Information Release Form
PDF template
A form for patients to authorize release of medical information and provide contact preferences for communication.
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Privacy Complaint Form
PDF template
A form for patients to submit written complaints regarding privacy and confidentiality of protected health information.
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HIPAA Privacy Authorization Form
PDF template
A form authorizing the use and disclosure of protected health information (PHI) in compliance with HIPAA regulations.
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Histology Service Request Form
PDF template
A form for requesting histology laboratory services with sample submission details and contact information.
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HSS Histopathology Service New Project Request
PDF template
A form for researchers to request histopathological services at the HSS Research Institute for investigating autoimmune, inflammatory, and orthopedic diseases.
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Medical History Form
PDF template
Comprehensive medical form for capturing patient health history, symptoms, and medical conditions across various body systems.
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HIV Case Report Form
PDF template
A comprehensive medical form for documenting HIV patient demographics, testing history, and risk factors.
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Hixny Electronic Data Access Consent Form
PDF template
A form allowing patients to consent or deny access to their medical records through the Healthcare Information Xchange of New York (Hixny) electronic network.
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Salisbury University Student Health Services Parental Consent Form
PDF template
A consent form for parents/guardians to authorize medical treatment for students under 18 at Salisbury University.
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Minors In Research Laboratories
PDF template
Procedure defining requirements and safety guidelines for minors under 18 participating in university research laboratory activities.
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Pediatric Provider Referral Form
PDF template
A form for healthcare providers to refer pediatric patients for additional services or evaluations.
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Hampton Roads HMIS Client Consent Form
PDF template
A consent form for sharing basic client information within the Homeless Management Information System (HMIS) for service coordination.
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Hampton Roads HMIS Client Consent Form
PDF template
A consent form for sharing client information within the Homeless Management Information System (HMIS) for service coordination.
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Hmsa Travel Assistance Request Form
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A form for requesting travel-related medical assistance or coverage through HMSA health plan
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MEDIA RELEASE FORM
PDF template
A legal document granting The Hockaday School permission to create, use, and distribute recordings of participants in school events.
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Harvard Outing Club Medical Form
PDF template
A comprehensive medical form for Outing Club members to provide emergency medical information and disclose health conditions that might impact trip participation.
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HOD COMMITTEE VOLUNTEER FORM
PDF template
A form for volunteering to serve on various committees for the House of Delegates meeting, including reference committees and other organizational groups.
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Risk Assessment Form
PDF template
A comprehensive form for identifying, evaluating, and mitigating workplace hazards and risks.
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Hooper DSC Referral Form
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A medical referral form for patient intake and scheduling at a healthcare facility with specific requirements and patient information collection.
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Hematology And Oncology Physician Coverage (HO PC) Service
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A document outlining objectives and expectations for physician coverage in Hematology and Oncology during nights and weekends.
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Horse Emergency Contact Form
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A form for collecting emergency contact details for a horse, including owner, veterinarian, and farrier information.
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Hospital Admission And Discharge Records
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A document discussing a new standardized form for recording psychiatric hospital patient admissions and discharges, with concerns about patient confidentiality.
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Hospital Discharge Form
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A form to document patient details and discharge readiness, including medical conditions and follow-up care requirements.
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Hospitalization Pre Authorization Form
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A comprehensive form for patients and healthcare providers to request pre-authorization for hospital admission and medical treatment from Jubilee Health Insurance.
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STD 236 Hotel Motel Transient Occupancy Tax Waiver
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Hot Topics In Broker Risk Reduction
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Legal document detailing NAR's proposed class action settlement related to broker commissions and MLS practices
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How To Choose The Correct Proof Of Insurance Form
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A decision tree for University of Illinois staff, faculty, students, and medical professionals to determine the appropriate proof of insurance form to submit.
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Medical Release Form
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Step-by-step guide for completing an online medical release form for Forest Home organization through CircuiTree registration account.
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How To Obtain A ConsumerS Authorization Before Gaining Access To Personally Identifiable Information
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Guidelines for Navigators and certified application counselors on obtaining consumer consent before accessing personally identifiable information in Federally-facilitated Marketplaces.
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Data Protection Consent Form
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A consent form for individuals to approve communication methods and data usage by the local parish council.
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HIGH PLAINS MUSIC CAMP MEDICAL FORM
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Comprehensive medical form for participants of High Plains Music Camp, collecting personal, medical, and emergency contact information.
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Health Professions Recruitment And Exposure Program 2022 Parental Consent Form
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Consent form for minor students participating in a medical education recruitment and exposure program at Weill Cornell Medical College.
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PARENTAL CONSENT FORM
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Consent form for minors to participate in the Health Professions Recruitment and Exposure Program at Weill Cornell Medical College.
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Entity Professional Liability Insurance Application
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An insurance application form for healthcare entities seeking professional liability coverage for their practice and healthcare professionals.
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Medical History Form
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Comprehensive form for documenting patient medical history, conditions, and potential health issues
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Health Reimbursement Account (HRA) Claim Form
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A form for employees to submit healthcare expense reimbursement claims through their Health Reimbursement Account (HRA)
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Active Local Government And Local Education Employee Group Employee Coverage WaiverReinstatement For
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Form for New Jersey state employees to waive or reinstate health benefits coverage under the State Health Benefits Program (SHBP) or School Employees' Health Benefits Program (SEHBP).
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FMLA LEAVE REQUEST FORM
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A comprehensive form for employees to request leave under the Family and Medical Leave Act (FMLA) for various qualifying reasons.
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International Travel Authorization Request
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A form for requesting and documenting international travel for university employees, students, and volunteers, including safety and risk assessment details.
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Claim Form
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A form for seeking reimbursement of eligible out-of-pocket expenses with participant certification and submission instructions.
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Health Savings Account 2023 Payroll Deduction Contribution Form
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Form for employees to start, stop, or change Health Savings Account (HSA) contributions through payroll deductions.
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Health Savings Account 2024 Payroll Deduction Contribution Form
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Form for employees to start, stop, or change Health Savings Account (HSA) contributions through payroll deductions for the 2024 plan year.
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Health Savings Account (HSA) Contribution Form
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A form for individuals to make contributions to their Health Savings Account through various deposit methods.
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Health Savings Account Employer Contribution Form
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A form for employers to make contributions to employee Health Savings Accounts with specific contribution details and authorization.
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Health Savings Account Payroll Deduction 2021
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Form for employees to authorize health savings account contributions through payroll deduction for qualified high deductible medical plans.
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BlueFund HSA Payroll Deduction Form
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A form for employees to set up payroll deductions for a Health Savings Account (HSA) with contribution guidelines and instructions.
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Health Savings Account (HSA) Transfer Request Form
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A form for transferring funds from an existing Health Savings Account (HSA) to a new HSA administered by Aptia and custodied by WEX Inc.
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Media Release Form
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Legal document authorizing the University of North Texas Health Science Center to use an individual's likeness for promotional purposes.
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Health Contact Form
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A bilingual form for tracking medical, dental, and health visits for foster children in Sonoma County
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Dual Enrollment Consent Form
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A document explaining FERPA rights and student privacy for dual enrollment students and their parents/guardians at Golden West College.
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High School Program Parent Permission And Consent Form
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Parent permission form for students participating in St. Joseph's College Bridge Program for high school students.
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Physical Examination Form
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A comprehensive medical physical examination form for nursing students at Mennonite College of Nursing, Illinois State University.
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HSR Special Risk Claim Form Fill Able
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Comprehensive guide for filing a special risk insurance claim, detailing required documentation and submission process.
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ParentGuardian Consent Form For Children And Youth
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A consent form for parents/guardians to authorize their children's participation in church-sponsored activities and provide medical information.
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State University Of New York Medical Reimbursement Form Claims Incurred Outside Of The United States
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A medical reimbursement form for SUNY employees and members to claim medical expenses incurred outside the United States.
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Prescription Reimbursement Form
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A form for submitting prescription drug expenses for insurance reimbursement, requiring patient and prescription details.
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Health Insurance Information
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Form for collecting student health insurance details and coverage acknowledgment for Hobart and William Smith Colleges students.
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ConnectHome Focus Group Consent Form
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A consent form for a HUD research study exploring community perspectives on home internet access through a focus group discussion.
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Authorization For The Release Of InformationPrivacy Act Notice
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A form authorizing the U.S. Department of Housing and Urban Development to request verification of personal financial information for housing assistance purposes.
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Human Informed Consent Form
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A template form for obtaining informed consent from research participants in science fair projects, ensuring ethical research practices.
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Special Olympics Massachusetts Release And Waiver Of Liability
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Liability waiver for participants in the 2019 Berkshire County Sheriff's Office Law Enforcement Torch Run Humvee Push event
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Huron Valley Percussion Physical Examination Form
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Comprehensive health screening form for student musicians detailing medical history and physician examination findings.
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Form I 508, Waiver Of Certain Rights, Privileges, Exemptions, And Immunities
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U.S. government form for individuals waiving certain rights, privileges, exemptions, and immunities, particularly for French nationals.
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Form I 508 Instructions For Waiver Of Certain Rights, Privileges, Exemptions, And Immunities
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Instructions for lawful permanent residents or applicants to waive diplomatic rights and privileges in order to retain or obtain U.S. permanent residence status.
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Form I 508 Waiver Of Certain Rights, Privileges, Exemptions, And Immunities
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A U.S. immigration form for individuals seeking to waive diplomatic rights and privileges to acquire or retain lawful permanent resident status.
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Form I 612
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A U.S. government form for requesting waiver of the two-year foreign residence requirement for certain exchange visitors.
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Form I 690, Application For Waiver Of Grounds Of Inadmissibility Under Sections 245A Or 210 Of The I
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Instructions for applying for a waiver of inadmissibility for Special Agricultural Workers or Legalization applicants under specific Immigration and Nationality Act sections.
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2020 DAY CAMP EMERGENCY CONTACT FORM
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A form for collecting camper and family information, emergency contacts, and medical permissions for a day camp program.
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Employee Emergency Contact Form
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A form for collecting employee personal and emergency contact details for workplace safety and emergency response purposes.
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MEDICAL HISTORY FORM TEMPLATE
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A comprehensive form for collecting patient medical information including medications, surgical procedures, illnesses, and vaccination history.
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NEAR MISS REPORT FORM
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A form used to document potential workplace hazards, safety concerns, and suggestions for preventing future incidents.
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Patient Discharge Form
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A comprehensive form for documenting patient discharge details, medical treatment, and follow-up information.
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Patient Intake Form Template
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A comprehensive form for collecting patient personal, medical, insurance, and payment information during initial healthcare visit.
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SAMPLE RISK ASSESSMENT FORM
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A comprehensive form for identifying, evaluating, and documenting potential risks across various categories and impact levels.
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Nursing Home Resident Fingerprint Consent Form
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Consent form for fingerprinting nursing home residents identified as potential offenders for criminal history record checks.
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IDS Fee Deadline Waiver Form
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A form for appointed attorneys to request a waiver of the one-year deadline for submitting fee applications to the Office of Indigent Defense Services.
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RELEASE FORM
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A legal document granting IEEE permission to use participant's media and content for various business and promotional purposes without compensation.
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Preparticipation Physical Evaluation Medical Eligibility Form
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Medical form for evaluating student-athlete's health and sports participation eligibility, including medical history and emergency contact information.
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Staff And Physician Q A Changes To Consent Policy Forms
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Detailed guidance on updates to medical consent forms, including new separate forms for different types of medical consent and procedures.
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Saint Ignatius High School FreshmanTransfer PHYSICAL EXAMINATION FORM
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Required medical examination form for freshmen and transfer students at Saint Ignatius High School, including health screening and medical history details.
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Immune Globulin Referral Form
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Medical referral form for patients requiring immune globulin treatment for various neurological and immune disorders.
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Public Law 94 437 Title I Scholarship Program Application Checklist
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Comprehensive application checklist for scholarship programs offered by the Indian Health Service for healthcare professionals and students.
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MRG MINI REGISTRATION FORM
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A registration form for patients at the Naval Health Clinic in Annapolis, Maryland, collecting basic patient demographic and contact information.
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ILCA Africa Fellowship 2022 Application Form
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Application form for research fellowship program by the International Liver Cancer Association targeting African researchers and medical professionals.
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Image ReproductionMedia Release Form (Minor)
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A form granting permission for Orange County Department of Education to use a minor's image, voice, and likeness for educational and media purposes.
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Media Release Form
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A legal document authorizing EAST Inc. to use an individual's personal media and likeness for marketing and promotional purposes
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Developmental Disabilities Supports Division (DDSD) Regional Office Request For Assistance RORA
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A form used to request assistance for individuals with developmental disabilities, addressing various service and support needs.
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Imaging Order Request
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A comprehensive medical imaging request form for various diagnostic scans and procedures
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NEW PATIENT INTAKE FORM
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Comprehensive medical form for collecting new patient personal, contact, and medical history information.
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INA Section 212(H) Waiver Form I 601
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A detailed explanation of the 212(h) waiver process for immigration cases involving criminal convictions that may impact legal permanent residency.
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Required Certificate Of Immunization
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A comprehensive form documenting required immunizations for students, including vaccination history and personal information.
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Immunization Consent Form
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A medical form capturing patient consent for immunizations, detailing potential adverse reactions and risks associated with vaccine administration.
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IMMUNIZATION CONSCIENTIOUSRELIGIOUSMEDICAL FORM
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A form for students to request exemption from immunization requirements due to conscientious, religious, or medical reasons
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Immunization Record Form
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A comprehensive form for documenting student immunization history and requirements for university enrollment.
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Authorization For Release Of MedicalHealth Information
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Missouri Department of Social Services form authorizing the release of an individual's medical and health information to specified parties.
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Indiana State University Immunization Waiver Form
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A form for students to claim medical or religious exemptions from required immunizations at Indiana State University.
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University Immunization Requirement Waiver Form
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A form for students to request exemption from university immunization requirements based on online-only enrollment or dual program status.
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IPL TEST REQUISITION FORM
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Medical form for submitting patient specimens for oncology immunophenotyping testing at Cincinnati Children's Hospital Medical Center laboratory.
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Parental Consent Form
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Consent form for students to participate in computerized concussion baseline testing program for athletic participation.
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Medical Permission And Media Release Form
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A comprehensive form for parental consent for youth participation in IMPACT activities and media usage rights for Bethel University.
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Incident Investigation Form
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A comprehensive form for documenting workplace safety incidents, investigating potential hazards, and recording detailed incident information.
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IncidentHazard Report Form
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A document used to report workplace incidents, hazards, and potential risks for churches, schools, or businesses.
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Incident Or Injury Form
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A comprehensive form documenting details of an incident or injury involving a child in a care facility.
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INCIDENT INJURY HAZARD REPORTING PROCEDURE
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A comprehensive procedure for reporting, investigating, and preventing workplace incidents, injuries, and hazards to ensure health and safety.
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Wildlife Incident Report Form
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A comprehensive form for documenting and reporting wildlife health incidents, including species details, environmental conditions, and collected specimens.
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INCIDENT, ACCIDENT, ILLNESS, DEATH OR ARREST REPORT
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A comprehensive form for documenting and reporting health-related incidents, accidents, illnesses, or other critical events in a community health network.
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Incident Report Form
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A comprehensive form for documenting details of an incident, including participant information, injury details, first aid, and follow-up actions.
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Incident Hazard Report Form
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A comprehensive form for documenting workplace incidents, injuries, hazards, and corrective actions within the Anglican Diocese of The Murray.
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ADMH DDD Incident Report Form For Incident Occurring During Provision Of Self Directed Services In I
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A form used to document and report incidents occurring during self-directed services for waiver program enrollees.
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Surveyor Agreement Form
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A legal agreement for surveyors conducting confidential income surveys for community development grant applications.
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Indemnity And Waiver Form For Acro Angels Gymnastics
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Legal document waiving liability for potential injuries during gymnastics activities at Acro Angels Gymnastics.
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Acrobranch Adventure Park Indemnity Form
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Comprehensive safety and liability waiver for participation in extreme sports activities at Acrobranch Adventure Park, outlining risks, safety guidelines, and participant responsibilities.
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Acrobranch Adventure Park Indemnity Form
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Legal waiver and safety guidelines for participating in extreme sports activities at Acrobranch Adventure Park, outlining risks, responsibilities, and participant obligations.
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Indicator Ownership Transfer Request Form
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A form for transferring unique animal indicator identification numbers between Canadian Livestock Tracking System (CLTS) accounts.
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Individual Membership Form
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A confidential membership form for individuals interested in joining the Narcolepsy Network organization with various membership levels and donation options.
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Individual Player Waiver Form
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A comprehensive waiver form for sports participants covering liability, medical information, and consent for activities at Crown Sports Center.
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Initial Disability Claim Form
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Insurance claim form for reporting initial disability claims, covering policyholder and patient information related to sickness or injury.
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33rd EACTS Annual Meeting Industry Opportunities Booking Form
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Registration and booking form for industry sponsorship opportunities at the 33rd European Association for Cardio-Thoracic Surgery Annual Meeting in Lisbon, Portugal.
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Industry Presentation Submission Form
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A form for submitting clinical research presentations for The Aesthetic MEET 2025 conference.
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Background Waiver Release Form
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A document authorizing background screening and information collection for employment or other purposes, with potential legal implications.
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Influenza Sample Submission Form
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A detailed form for submitting influenza test samples to the South Dakota Public Health Laboratory with comprehensive patient and specimen information.
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Limited License Fee Waiver Affidavit Form
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A form for employers to certify that a volunteer physician will not receive monetary compensation, enabling a fee waiver for medical licensure.
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Information Release Consent Form
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A form allowing University of Wisconsin-Parkside students to consent to release of their educational and financial records to specified parties.
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Informant Interview Form Instructions
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Instructions for completing an interview form about a participant through a close contact when direct participant data collection is not possible.
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Information For Potential Research Volunteers Who Complete MCW On Line Webforms
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Document outlining data collection, usage, and privacy practices for medical research volunteer webforms at Medical College of Wisconsin.
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Informed Consent Form Template Instructions
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A comprehensive guide and template for creating an informed consent document for research studies, providing instructions and structure for researchers.
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Informed Consent And Liability Waiver Form
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A consent form detailing patient rights, treatment expectations, and liability release for physical therapy services.
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Consent For Operation, Anesthesia, Procedures And Medical Services
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A consent form for patients agreeing to a medical procedure, specifically a colonoscopy, outlining risks, benefits, and patient rights.
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Informed Consent Form
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A consent form for individuals applying for or receiving long-term care assistance, authorizing medical record access and assessment.
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Informed Consent Form
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A template for obtaining voluntary participant consent for a research study, outlining study details, risks, benefits, and participant rights.
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UNIVERSITY OF PENNSYLVANIA RESEARCH SUBJECT INFORMED CONSENT AND HIPAA AUTHORIZATION FORM
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Informed consent document for participation in medical research biobank involving genetic and biological sample collection and research studies.
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Informed Consent Process
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Comprehensive guidelines for obtaining voluntary and informed consent from research subjects, detailing requirements, exceptions, and federal regulations.
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Example Informed Consent For An Anonymous Online Survey
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Informed consent document for a research study examining consumer attitudes towards online shopping, conducted anonymously with university students.
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Winston Salem State University Informed Consent Form
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A template document for obtaining voluntary participant consent for a research study, outlining study details, procedures, and participant rights.
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TREATMENT CONSENT FORM
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Consent form for behavioral health, substance use treatment, vocational, and audiology services provided by Catalyst Life Services.
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TREATMENT CONSENT FORM
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A consent form for patients receiving behavioral health, substance use, vocational, and audiology services from Catalyst Life Services.
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Informed Risk Agreement
PDF template
A voluntary document for documenting risks, participant choices, and mitigation strategies in support coordination services.
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Informed Risk Insurance Form For Allied Health Students
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A document detailing potential infectious disease risks for allied health students and insurance requirements during clinical studies.
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PLASTIC COSMETIC CENTER IN HOUSE FINANCING FORM CREDIT CHECK
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A comprehensive form for patients seeking in-house financing for cosmetic procedures with credit authorization.
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Individual Authorization And Consent Form For Child Care Criminal Background Check Based Determinati
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Authorization form allowing Louisiana Department of Education to conduct comprehensive criminal background checks for child care providers
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INITIAL CONTACT FORM (ICF)
PDF template
Comprehensive intake form for patient medical, substance use, and treatment history for healthcare services.
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Initial Disability Claim Form
PDF template
Insurance claim form for reporting initial disability claim with details about injury, hospitalization, and patient information.
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Initial Uniform Health Assessment Form
PDF template
A comprehensive health evaluation form for medical professionals to assess fitness for duty and potential health risks to patients.
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Nursing Education Program Medical Form
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Medical form required for students entering the Jefferson State Community College Nursing Program, documenting health status and immunizations.
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Medical History Form
PDF template
Comprehensive medical history questionnaire used by Egea Medical Weight Loss Center to collect patient health information and background.
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Initial Disability Claim Form
PDF template
Insurance claim form for reporting initial disability due to sickness or injury, used by Aflac to process insurance claims.
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Form D Student Injury Report Form
PDF template
A form used to document and report student injuries or exposures during academic or clinical activities.
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INNOVATION GRANT APPLICATION FORM
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A comprehensive application form for researchers seeking innovation grants from the British Medical Ultrasound Society (BMUS)
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Consent Form For Blood Spot Collection Testing (IRB 09 026A)
PDF template
A consent form for a medical research study involving blood spot collection and testing for health risk assessment purposes.
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Reimbursement Account Claim Form
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Claim form for submitting healthcare and dependent care expenses for reimbursement through a flexible spending account or reimbursement account.
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Probate Court Post Appointment Risk Assessment Tool
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A tool for Arizona probate courts to assess risks and conduct independent case reviews for guardianship and conservatorship cases.
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CMS 1500 Claim Form Instructions
PDF template
Detailed instructions for completing the CMS 1500 form for medical service billing to SFHP by healthcare providers.
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INSTRUCTIONS FOR MEDICAL REQUIREMENTS FOR CONDITIONALLY APPOINTED APPLICANTS
PDF template
Detailed guidelines for completing medical forms for conditionally appointed VMI applicants through the Medicat Portal.
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INSTRUCTIONS FOR PRE AUTHORIZATION FORM
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Detailed instructions for completing a pre-authorization form for medical procedures and services at Kaiser Permanente.
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Request For Waiver Of Competitive Bidding
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Guidelines for requesting a waiver from standard competitive bidding procedures at The Ohio State University for specific procurement circumstances.
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Insurance Affidavit
PDF template
Document detailing Webber International University's requirements for student health insurance coverage and opt-out process for the academic year.
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Dental Insurance Information
PDF template
Insurance form for collecting patient dental insurance details and treatment consent
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Insurance Information And Authorization Form
PDF template
Medical insurance and patient authorization document for Drs. Mark and Suzanne Boas' eyecare practice, collecting patient insurance details and financial responsibilities.
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Student Athlete Insurance Information Form
PDF template
A comprehensive insurance information form for student-athletes at Kutztown University to provide medical and contact details.
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Insurance WaiverChange Of Address
PDF template
A document for patients to waive insurance coverage and update contact information for medical services.
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EMPLOYEE WAIVER OF HEALTH INSURANCE FORM
PDF template
Form for employees to waive group health insurance coverage due to alternative coverage.
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Insuring Technology Risks In A Professional Environment
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A white paper addressing technology-related risks and insurance considerations for professional engineering practices.
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Consent To Treat
PDF template
A legal document authorizing medical treatment and explaining patient rights under HIPAA privacy regulations.
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Patient Intake Form
PDF template
Patient intake document providing contact information for multiple PanCare Health medical and dental clinics across Florida counties.
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Patient Intake Form
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A comprehensive medical intake form for collecting patient personal and health information for acupuncture treatment.
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Patient Intake Form
PDF template
A comprehensive patient intake document for collecting detailed personal, medical, and contact information at a memory clinic.
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Adult Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, emergency, and insurance information for medical treatment.
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New Patient Intake Form
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Comprehensive form for collecting patient demographic, contact, insurance, and scheduling information for new healthcare patients.
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NEW PATIENT INTAKE FORM
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Comprehensive medical and insurance information form for new patients, focusing on vision and health insurance details.
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Patient Intake Form
PDF template
Comprehensive medical intake form for new chiropractic patients to document personal information, health history, and current medical conditions.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive patient intake form for podiatry medical practice collecting patient information, medical history, and insurance details.
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Patient Intake Form
PDF template
Comprehensive patient intake form collecting personal information, medical history, insurance details, and pre-examination assessment for medical treatment.
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Neighborhood Health Plan Of Rhode Island (NHPRI) DME Authorization Form
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Healthcare authorization form for durable medical equipment (DME) services from Neighborhood Health Plan of Rhode Island
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Orthopaedic Surgery Program Intent To Travel Form
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A form for documenting and requesting travel reimbursement for residents in the Orthopaedic Surgery Program with details about mileage and funding sources.
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ChildrenS Division Division Of DD Interdivisional Service Agreement
PDF template
A service agreement between Children's Division and Division of Developmental Disabilities for funding and supporting a child's care and services until their 21st birthday.
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International Claim Form
PDF template
A comprehensive form for submitting international healthcare insurance claims with patient and coverage details.
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Generali Worldwide Health Insurance Healthcare Pre Authorization
PDF template
A pre-authorization form for healthcare services requiring insurance approval and documentation for Generali Worldwide Health Insurance.
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Health Insurance Pre Authorization Form For Therapy
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Insurance form for pre-authorization of physical, occupational, speech, and chiropractic therapy treatments.
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BOBST INTERNATIONAL CENTER SERVICE REQUEST FORM
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A comprehensive form for patients seeking medical services, including travel, consultation, and treatment details.
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Global Sights Photo Contest Media Release Form
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A legal document granting Minot State University permission to use photographic or video content featuring the signee.
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INTERNATIONAL REALTOR MEMBER REFERRAL FORM
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A standardized form for REALTOR members to document referral agreements and commission sharing between brokers and agents.
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International Student Medical Form
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Comprehensive medical form for international students attending community colleges in North Carolina, capturing personal and medical information.
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Intern Medical Treatment Authorization Form
PDF template
Medical authorization form for interns to provide emergency treatment details and contact information in case of medical incidents.
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StudentInternPracticum Application
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Application form for students seeking internship or practicum placement at a community mental health center
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Internship Waiver Checklist
PDF template
A document outlining the process for waiving an internship requirement for students with prior teaching experience in special education at George Mason University.
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Interventional Radiology Referral Form
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Medical referral form for various interventional radiology procedures and services at Cincinnati Children's Hospital Medical Center
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Entry Medical Examination United Nations And Specialized Agencies
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Medical examination form for employment candidates seeking positions with United Nations and specialized agencies, requiring comprehensive health disclosure and authorization for medical record review.
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Waukee Community Education Intramural Waiver Form
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A consent and release form for students participating in Waukee Community Education intramural programs, acknowledging risks and providing medical authorization.
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Victim Of Trafficking Screening Interview Form
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Confidential interview form for identifying and documenting potential victims of human trafficking for support and assistance purposes.
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Risk Assessment Form
PDF template
A comprehensive form for identifying, evaluating, and managing workplace hazards and potential risks.
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IPAC Application Form
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Application form for research project consultation and imaging analysis services at a medical research facility.
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Data Protection Consent Form For Athletes
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Consent form for athletes regarding transfer of World Para Snow Sports governance from IPC to International Ski and Snowboard Federation (FIS)
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Data Protection Consent Form For Athletes
PDF template
Consent form for athletes regarding the transfer of Para dance sport governance from IPC to World Abilitysport
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Media Release Form
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A consent form allowing Youth Services System to use photographs and videos of individuals for media and promotional purposes.
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Informed Consent Form (Audiotape)
PDF template
A consent form for audio recording and transcribing research interviews with privacy protections and participant rights.
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Informed Consent Form
PDF template
A standard template for documenting informed consent for research studies, outlining participant rights and study details.
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IRB Application Checklist
PDF template
A comprehensive checklist for preparing and submitting an IRB application for research involving human subjects.
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UMassD IRB Class Project Form
PDF template
A form for students to submit class research projects for IRB review and confirmation of project designation.
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Consent Form Checklist
PDF template
A comprehensive checklist for creating research consent forms at North Park University, covering required elements and sections for documentation.
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Consent Form Checklist
PDF template
A comprehensive checklist for researchers preparing consent forms for human participant research projects at Northwest University.
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FORM D CONSENT FORM TEMPLATE
PDF template
A template for creating a consent form for research study participants, outlining study details, procedures, risks, and benefits.
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Informed Consent For Research Participation
PDF template
A template for obtaining informed consent from research study participants at Washburn University.
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Informed Consent For Participation Of A MINOR In A Research Study
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A legal document obtaining parental consent for a minor's participation in a research study, outlining study details and participant rights.
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Research Participant Information And Informed Consent Form
PDF template
Guidelines for creating a research study consent form with template sections and formatting recommendations.
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Behavioral Science Parental Consent Template
PDF template
Detailed guidelines for creating parental consent forms for behavioral and social science research studies involving children.
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Wheaton College Institutional Review Board (IRB) Research Proposal For Human Participants
PDF template
An official document for researchers to submit research proposals involving human participants for review and approval by Wheaton College's Institutional Review Board.
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Sample Assent Form For Child
PDF template
A template form for obtaining a child's voluntary agreement to participate in a research study with parental consent.
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IRCP Medical History Form
PDF template
Comprehensive medical history form for patients with polio, capturing details about diagnosis, hospitalization, symptoms, and current health status.
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International Relations Summer Institute Media Release Form
PDF template
A consent form allowing Seton Hall University to use photographs, videos, and recordings of a participant's image, voice, name, and quotes for university purposes.
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ISA Basic Tree Risk Assessment Form
PDF template
A standardized form for conducting basic tree risk assessments, providing guidance for collecting and recording information about tree conditions.
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Property Owner Consent Form
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A form authorizing a designated representative to allow access and participation in an annual property easement monitoring visit.
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Is It An Emergency
PDF template
A guide to recognizing and responding to medical emergency warning signs for adults and children.
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Cancellation Form
PDF template
Form for cancelling enrollment in Medica health insurance plans with multiple reason options.
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ISS Trip Liability Waiver Form
PDF template
A legal waiver form for students participating in an ISS trip, releasing the University at Buffalo from liability for potential injuries or damages.
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WELLNESS CENTER LIABILITY WAIVER
PDF template
A comprehensive liability waiver for participation in university wellness center activities and events, acknowledging risks and releasing the university from potential claims.
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MCSA 5870 Insulin Treated Diabetes Mellitus Assessment Form
PDF template
A medical form used to evaluate individuals with insulin-treated diabetes mellitus for commercial motor vehicle operator qualification.
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IRB Application
PDF template
A comprehensive form for researchers to submit detailed information about a proposed research project for ethical review and approval.
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Outpatient Physician Visit Referral Form
PDF template
A medical referral form for patient transfer between healthcare providers, collecting patient and referral details.
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J88 Report On A Medico Legal Examination
PDF template
Official form for documenting medical findings in legal investigations, completed by healthcare practitioners for forensic purposes.
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J 1 Visa Application For Prospective UTSW International Visitor
PDF template
Comprehensive application package for international trainees seeking J-1 visa sponsorship at UT Southwestern Medical Center.
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Release And Waiver Of Liability And Indemnity Agreement To Jeep Adventure Academy
PDF template
Legal waiver and liability release form for participants in Jeep Adventure Academy off-road events, outlining participant responsibilities and risk acknowledgment.
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REGISTRATIONWAIVER FORM Junior Chefs Of America, Inc.
PDF template
A comprehensive registration form for children's culinary program that includes personal, emergency contact, and medical information.
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Patient Intake Form
PDF template
Comprehensive medical intake document collecting patient personal, contact, insurance, and consent information for medical services.
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Accident Waiver And Release Of Liability Form
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Legal document releasing liability for participants in an event or activity organized by the Society of American Military Engineers (SAME).
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Medical Release Form
PDF template
A form for documenting participant medical history, conditions, medications, and emergency contact information.
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Journal Of Hospital Medicine Author Contribution Form
PDF template
A form detailing authorship guidelines and contributions for a medical research manuscript submission.
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FOBT FOLLOW UP FORM
PDF template
A medical chart audit form for tracking patient follow-up after a positive fecal occult blood test (FOBT) result in a colorectal cancer screening study.
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Jeep Jamboree Waiver And Release Of Liability
PDF template
Legal waiver for participants in Jeep Jamboree off-road events, releasing organizers from liability and setting vehicle participation requirements.
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Urgent Care Application For Employment
PDF template
Comprehensive employment application for various medical positions at an urgent care facility, including equal opportunity and work authorization sections.
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Medical Alert Form
PDF template
Medical information form for students using Johnson Bus Company transportation services in Menomonee Falls School District.
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HCP Referral Form
PDF template
A comprehensive referral form for healthcare coordination and client information collection
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Fresh Osteochondral Allograft And Fresh Frozen Meniscus Order Form
PDF template
Medical order form for requesting fresh osteochondral allografts and meniscus grafts for surgical procedures.
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Medical Examination Physician Statement
PDF template
A medical examination form for visa applicants requiring documentation of medical screening by an embassy-approved physician.
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Authorship Contribution Form
PDF template
A form documenting author contributions for manuscript submission to medical journal publications.
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Scholar Health Insurance Waiver Form 2024 2025
PDF template
A health insurance waiver form specifically designed for international J-1 scholars and their J-2 dependents at the University at Buffalo.
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Junior Treekeeper Camp Accident Waiver And Release Of Liability
PDF template
A legal document waiving liability for participants in a youth camp program, acknowledging potential risks and releasing event organizers from legal responsibility.
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Junior Volunteer Application
PDF template
Application for teenagers aged 15+ interested in volunteering at Valley View Hospital healthcare facility.
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Medical Form
PDF template
A comprehensive medical history form for applicants to the JVC Northwest program, to be completed by a healthcare professional.
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Authorship Responsibility And License Agreement Form
PDF template
A form for authors to transfer copyright, affirm originality, and declare publication standards for the Journal of Veterinary Science.
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Member Reimbursement Form For Medical Claims
PDF template
A comprehensive form for submitting medical claim reimbursement requests, including patient and provider details.
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Peralta Community College District Reimbursement Form
PDF template
Form for Peralta Community College District employees and retirees to claim medical expense reimbursements based on specific eligibility criteria.
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Dengue Report Form
PDF template
Medical reporting form for collecting patient information related to dengue fever cases in Kansas, used for public health tracking and epidemiological research.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for patients seeking joint replacement or orthopedic consultation, collecting detailed medical history and symptom information.
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Personal Care Risk Assessment Form
PDF template
A comprehensive form for evaluating risks in personal care settings, covering physical hazards, client safety, health, and support worker wellbeing.
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Veterinary Resources Key Receipt Authorization
PDF template
A form documenting the authorization and receipt of keys for animal research facilities with specific return and usage guidelines.
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Media ReleaseConsent Form For The Parent Or Guardian Of A Minor
PDF template
A legal document granting permission for the William & Sheila Konar Foundation to use a minor's image, likeness, and personal information for various media purposes.
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KHC And KHCNVL Alternate Requisition Form
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Medical requisition form for various heart-related diagnostic tests with detailed patient instructions and testing protocols.
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Fertility Assessment Form
PDF template
A detailed medical form for couples assessing fertility challenges and medical history related to reproductive health.
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KindCare Hazard And Risk Assessment Form (Infection Risks)
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A document for evaluating potential hazards and risks related to infection in a healthcare or workplace setting.
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Kindergarten Waiver Form
PDF template
A form allowing parents to request a delay in kindergarten entry for their child according to school policy.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting new patient personal, contact, and health provider information
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Consent For Administration Of Health Treatment AndOr Medication At School
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A form for parents and healthcare providers to authorize medical treatments and medication administration during school hours.
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Marriage License Consent Form
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A legal document allowing parents or guardians to provide consent for a minor's marriage.
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Authorship Responsibility And License Agreement Form
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A form for authors to transfer copyright, confirm originality, and declare responsibilities when submitting a manuscript to the Journal of Veterinary Science.
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Evaluating Drivers And Issuing The Medical Report Form
PDF template
Guidelines for DMV staff to assess a driver's medical fitness and ability to operate a motor vehicle safely.
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MEDIA RELEASECONSENT FORM
PDF template
A legal document allowing the William & Sheila Konar Foundation to use an individual's name, image, and likeness for various media and promotional purposes.
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Member Reimbursement Form For Over The Counter COVID 19 Tests
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A form for Kaiser Permanente members to request reimbursement for over-the-counter COVID-19 test purchases.
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KSPCData ProtectionConsent Form
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A consent form for collecting personal contact information and communication preferences for the Kirk Smeaton Parish Council.
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Accident Waiver And Release Of Liability Form
PDF template
A legal document that releases event organizers from liability and confirms participant's physical fitness and voluntary participation.
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Accident Waiver And Release Of Liability Form
PDF template
A legal document that releases event organizers from liability and confirms participant's fitness and understanding of potential risks.
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PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
A comprehensive health screening form for students entering Kentucky public schools, documenting medical history and physical examination results.
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Kentucky Immunization Registry Enrollment
PDF template
Instructions for healthcare providers to enroll in the Kentucky Immunization Registry and create user accounts.
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PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
Required health examination form for Kentucky public school students entering school or sixth grade, documenting medical history and physical screening results.
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Community Supports Medically Tailored Meals (CS MTM) Referral Form For MCLA CMC Members Only
PDF template
Referral form for L.A. Care Health Plan members to enroll in a Medically Tailored Meals Program with specific chronic condition eligibility criteria.
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LABORATORY SAFETY CHECKLIST (FORM 3010)
PDF template
A comprehensive safety checklist designed to ensure awareness and compliance with laboratory safety policies and procedures for employees and visitors.
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Laboratory Services Outpatient Lab Requisition
PDF template
A comprehensive form for ordering laboratory supplies, collection containers, and specifying test requirements for various medical specimens.
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Leukemia Diagnostic Test Request Form
PDF template
Medical form for submitting patient specimens for leukemia-associated diagnostic testing and immunophenotype analysis.
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Lab Requisition
PDF template
Medical form for ordering and documenting various laboratory diagnostic tests and panels.
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Boise State UniversityS Lab Waiver Of Liability And Assumption Of Risk
PDF template
A legal document granting parental permission and outlining liability terms for students participating in Boise State University lab programs.
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Chronic Illness Benefit Application Form
PDF template
Application form for patients seeking chronic illness benefits through LA Health Medical Scheme, requiring patient and medical professional details.
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My Medical Info
PDF template
A comprehensive medical information form designed to provide critical health details for emergency personnel in case of medical emergencies.
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Bessie Marshall Benefit Fund Instructions
PDF template
Detailed instructions for members to apply for weekly benefits in case of sickness or injury, with specific eligibility requirements and limitations.
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Ladies Auxiliary To The Maryland State FiremenS Association Bessie Marshall Benefit Fund Instructi
PDF template
Benefit fund guidelines for sick or injured members of the Maryland State Firemen's Association providing weekly financial assistance under specific conditions.
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PROOF OF DISABILITY CLAIM FORM
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A form for employees to document and claim disability benefits through the Labor Alliance Managed Trust Fund.
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NATIONAL STANDING ORDER FORM
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Medical transportation request and service authorization form for patient transportation services
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Interpreter Waiver Form
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Legal document allowing a party in a court proceeding to voluntarily waive the right to an interpreter services.
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Laser Operations Safety Audit Form
PDF template
A comprehensive safety audit form for documenting laser operation safety compliance and inspection of various laser classes.
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CPUC Local Agency Technical Assistance Program Consent Form
PDF template
A consent form for local agencies and tribes to acknowledge and accept terms for a California Public Utilities Commission grant.
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Authorization For Release Of Information And Liability Waiver
PDF template
Legal document authorizing disclosure of employment files for law enforcement job candidates in Wisconsin, with liability release provisions.
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Parent Or Guardian Consent Form
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Form for parents or guardians to consent to employment of minors aged 16-17 during summer vacation months.
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INSURANCE PRE AUTHORIZATION FORM
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A form for collecting client and insurance details for pre-authorization of therapeutic services.
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Legacy Community Health Client Intake
PDF template
Comprehensive patient intake form for collecting personal and medical contact information for Legacy Community Health services.
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Forsyth County Waiver Form For Open Burning Within 500 Feet Of Occupied Dwellings
PDF template
A form allowing open burning near occupied structures with signed permission from nearby residents or property owners.
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LEAVE OF ABSENCE REQUEST FORM
PDF template
Detailed guidelines for employees requesting a leave of absence, including required documentation for various types of leave.
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Leave Request Form
PDF template
A form for employees to request various types of leave, including family medical, annual, compensatory, and sick leave.
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Leave Of Absence Request Form
PDF template
A comprehensive form for employees to request various types of leave, including personal, medical, and family-related absences.
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Anne Arundel County Pre Employment Physical Agility Test For Entry Level Deputy Sheriff (Non County
PDF template
Legal waiver for non-county employees participating in a physical agility test for entry-level deputy sheriff positions in Anne Arundel County, Maryland.
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Risk Assessment Form
PDF template
Safety assessment for school visits to museum covering transportation, courtyard, and general hazards for teachers and students.
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Letter Of Authorization
PDF template
A document allowing a third party to submit and manage a passport application on behalf of an individual, with specific consent provisions.
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Disability Claim Form
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A comprehensive form for employees to file a disability claim, documenting injury/illness details, personal information, and income sources.
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New Patient Past Medical History Form
PDF template
Comprehensive medical history form for new patients to provide personal, medical, and family health information.
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LHC Supplemental Medical 2023 Update23
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Medical form for Laurel Highlands Council camp registration requiring health information and medication permissions for scouts
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Preparticipation Physical Evaluation Physical Examination Form
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A comprehensive medical evaluation form for athletes to assess physical fitness and health status prior to participation in sports activities.
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Release And Waiver Of Liability And Indemnity Agreement
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Legal document releasing the Winona Family YMCA from liability for injuries or damages during facility use or program participation.
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Accident Waiver And Release Of Liability Form
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Legal document releasing The First Tee of San Antonio from liability for potential injuries or damages during volunteer activities.
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Teen Entrepreneur Academy (TEA) Liability Medical Release Form
PDF template
Liability and medical release form for participants in the Teen Entrepreneur Academy program at Concordia University, Irvine.
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Liability And Photo Media Release Form
PDF template
A comprehensive release form for participants covering liability, health insurance, and media usage rights for museum activities.
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Assumption Of Risk, Waiver Of Liability And Indemnification Agreement
PDF template
Legal document for participants to assume risks and waive liability for University of Utah program or event activities.
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Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
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A comprehensive legal document that releases MetamorphiiFit Fitness Society from liability for potential risks and injuries during fitness programs and activities.
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Liability Media Release Form Required Of All Students
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A legal document for student registration that includes liability waiver and media release permissions for Community Music School activities.
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UNIVERSITY DAY LIABILITY RELEASE FORM
PDF template
A legal document for releasing liability and providing medical consent for campus visitors to Franciscan University of Steubenville.
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Waiver Of Liability And Hold Harmless Agreement
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Legal document releasing College of the Mainland from liability for potential injuries or damages during an activity.
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Liability Waiver Form Adult Student (18 YrsOlder)
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A legal document waiving liability for adult students participating in service-learning activities at a college.
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Liability Release And Assumption Of Risk For Activity Participation And Local Travel
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A legal document releasing the University of Maryland, Baltimore County (UMBC) from liability during an activity or travel event
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Liability Release
PDF template
A legal document releasing Laredo College from liability for potential injuries during a student activity or trip.
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Liability, Risk Acknowledgment, And Claims Release Form
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A legal document for participants to acknowledge risks and release claims for activities sponsored by Los Angeles City College.
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Release Liability Medical Release Form
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A comprehensive form for collecting student medical information, emergency contacts, and liability release for a summer orientation program
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ToursClasses Liability Release
PDF template
A comprehensive liability release for kayaking and stand-up paddleboarding tours and classes, acknowledging inherent risks and waiving legal claims.
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Release And Indemnity Agreement
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A legal document that releases Southern Adventist University from liability for risks associated with student, employee, or volunteer activities.
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Liability Waiver Form Shoreline Cleanup
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Waiver for volunteers participating in shoreline cleanup activities at Blowing Rocks Preserve, outlining risks and participant responsibilities.
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Liability Waiver
PDF template
A legal document releasing the University of Indianapolis from liability for injuries or damages that may occur during participation in university activities.
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Waiver, Indemnification, And Media Release Form
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Legal document releasing Houston Christian University from liability for participants in university events and activities.
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Liability Waiver Form
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A legal document waiving liability for potential health risks associated with consuming food at student-organized events.
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Arkansas Tech University Student Liability Waiver
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A comprehensive liability waiver for students participating in on or off-campus university activities, outlining participant responsibilities and risks.
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Permission Form For Minors With Indemnity Agreement And Emergency Contacts
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A consent and liability waiver form for parents/guardians allowing minor children to participate in a diocesan event with legal indemnification provisions.
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PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for health assessment and licensing purposes.
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Murray State College Veterinary Nursing Program Veterinary Technician Licensure
PDF template
Comprehensive guide for veterinary nursing students seeking state licensure and national exam eligibility across different states.
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Waiver Of Construction Lien
PDF template
A legal document used to waive construction lien rights for specific work performed on a property under Wisconsin state law.
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VENDOR AGREEMENT
PDF template
A vendor participation agreement for the Lights On! festival with liability waiver and event guidelines.
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Medical Release Form
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A comprehensive medical consent and release form for students at Lyndon Institute's Boarding or Summer Program, granting medical treatment permissions and health information sharing.
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Limestone College Medical Consent Form
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A medical consent form for collecting student medical history and immunization records to support health monitoring and campus safety.
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Form IV Application For Limited Registration As A Health Practitioner
PDF template
Application form for foreign health professionals seeking temporary registration to practice in Zambia for up to six months.
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Linkage To Care Referral Form
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A referral form for HIV intervention, medical care linkage, and patient tracking across various healthcare programs
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Medical IncidentAccident Report
PDF template
A comprehensive form for documenting medical incidents or accidents, detailing injury specifics and first aid procedures.
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Indiana Regional MLS Listed Coming Soon Status Frequently Asked Questions
PDF template
Guidelines for using the 'Listed Coming Soon' status in real estate listings with delayed showing dates in the Indiana Regional MLS.
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Litchfield School District Student COPPA Compliance Form
PDF template
Parental consent form for children under 13 to use web-based educational applications and tools in compliance with COPPA guidelines.
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LitCoin NLP Challenge ParentLegal Guardian Consent Form
PDF template
Consent form for parents or legal guardians of minors participating in the LitCoin NLP Challenge, granting permission and releasing liability.
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Group Literature Order Form
PDF template
Order form for purchasing Narcotics Anonymous literature, books, pamphlets, and recovery materials
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Cheerleading Waiver Form
PDF template
Registration and medical consent form for school district cheerleading camp for youth participants.
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Leave Of Absence Request Form
PDF template
A comprehensive form for employees to request extended time off for various personal, medical, or family-related reasons.
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Lodging Waiver Form
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A form for requesting a waiver for exceptional circumstances involving faculty/staff lodging with students during travel.
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Lodging Waiver Form
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A form for requesting approval to lodge with MSU students under special circumstances, requiring compliance and risk management review.
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Disability Claim Form FL
PDF template
A comprehensive form for filing a disability insurance claim with detailed sections for employer and employee information.
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Student Blanket Insurance Policy Disability Claim Form
PDF template
A comprehensive form for students to file a disability insurance claim, documenting medical conditions, educational status, and treatment details.
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Tree Hazard Evaluation Form
PDF template
A comprehensive form for evaluating tree hazards and characteristics by a qualified arborist for risk assessment purposes.
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RISK ASSESSMENT FORM
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Comprehensive risk assessment form for evaluating potential hazards and safety risks during travel.
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Trips And Visits Medical And Consent Form
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A comprehensive medical and consent form for students participating in a school trip, collecting health and emergency contact information.
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Physician Referral Form
PDF template
A form used to facilitate patient referrals between healthcare providers, capturing patient and referring physician details.
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Volunteer Agreement Waiver
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A volunteer agreement form for individuals interested in volunteering with Baltimore County Department of Recreation and Parks and Lake Roland Nature Council.
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NJCAALake Superior College Physical Examination Form
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Medical certification form for student athletes participating in National Junior College Athletic Association intercollegiate sports.
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Group Health Claim Form
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A comprehensive form for submitting healthcare claims for employees, spouses, and dependents under the LSU First Health Plan.
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LTBB Media Release Form
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A media release authorization form allowing LTBB to use participant images, audio, and video for promotional and educational purposes.
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LTBB Permission And Medical Release Form
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A form providing authorization for medical treatment and participation in LTBB department and program events, including emergency contact information.
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Consent Form Notice To Facility For Authorized Electronic Monitoring
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A consent form for residents or their representatives to authorize electronic monitoring in healthcare facility rooms, detailing video and audio recording preferences.
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Ombudsman Disclosure Consent Form
PDF template
A consent form allowing residents of licensed facilities to authorize release of investigation findings to specified individuals by the State Long-Term Care Ombudsman.
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Long Term Disability Claim Form
PDF template
A claim form for employees to submit long-term disability insurance claims with personal and medical information.
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Disability Claim Form
PDF template
A comprehensive form for filing a disability insurance claim, requiring input from the member, plan sponsor, and attending physician.
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Group Long Term Disability Claim Form
PDF template
A comprehensive claim form for employees seeking long-term disability benefits, requiring details from both the employee and attending physician.
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Long Term Disability Claim Form Statement Of Employer
PDF template
A form used by employers to submit details for an employee's long-term disability insurance claim with Lincoln Financial Group.
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McKenzie Institute International Lumbar Spine Assessment
PDF template
Comprehensive medical assessment form for evaluating lumbar spine conditions, symptoms, and patient history.
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McKenzie Institute International Lumbar Spine Assessment
PDF template
Comprehensive medical assessment form for evaluating patient's lumbar spine condition, symptoms, and functional limitations.
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Fax Referral Form
PDF template
A comprehensive medical referral form for patient information, insurance details, and provider selection in pulmonary and sleep medicine.
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Lutheridge Adult Medical Form
PDF template
A comprehensive medical form for collecting health and emergency contact information for adult participants at Lutheridge camp.
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Lutheridge Camper Medical Form
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Comprehensive medical and registration form for children attending Lutheran church camp programs, capturing health information, emergency contacts, and medication details.
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Lutherock Camper Medical Form
PDF template
Comprehensive medical and emergency contact form for children attending Lutheran summer camp programs
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Luther Springs Camper Medical Form
PDF template
Medical and emergency information form for children attending Luther Springs summer camp programs
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LEHIGH UNIVERSITY WAIVER And RELEASE OF LIABILITY FORM For ACTIVITIES OFF CAMPUS
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A legal document that releases Lehigh University from liability for potential injuries or losses during off-campus activities or trips.
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Liability Waiver Form
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A municipal form for waiving insurance requirements for building and construction-related permit applications in Boston.
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Lynchburg IRB Quick Reference Guide
PDF template
A comprehensive guide for researchers outlining the Institutional Review Board (IRB) consent process, ethics training requirements, and proposal submission steps.
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Test Requisition Form
PDF template
Medical test requisition form for collecting patient specimen information and diagnostic testing details.
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Test Requisition Form
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Medical form for collecting patient and specimen information for specialized laboratory testing.
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21st Maccabiah Medical Form
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Medical clearance form for athletes, coaches, and staff participating in the 21st Maccabiah sporting event requiring physician certification of health status.
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Emergency Contact Form
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A form for parents to provide comprehensive emergency contact, health, and medical information about their child
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Medical Claim Form
PDF template
A form for submitting out-of-network medical claims for reimbursement by UnitedHealthcare for Pennsylvania members.
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NBPS Magnus Instruction Changing Credentials
PDF template
Comprehensive guide for parents to complete online health documentation and enrollment forms for students at Notre Dame school
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MA Health Care Coverage Waiver Form
PDF template
Form for employees to decline employer-sponsored health insurance coverage with options for alternative coverage
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Major Or Minor Waiver Or Substitution Form
PDF template
A form for students to request substitution or waiver of specific academic major or minor requirements at an educational institution.
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Male Medical History Form
PDF template
A comprehensive medical history form specifically designed for male patients to record personal and family health information.
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Male Medical History Form
PDF template
Comprehensive medical history form specifically designed for male patients, covering sexual health, medical conditions, and personal health background.
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Professional Liability Insurance Form
PDF template
Form for medical doctors to provide professional liability insurance details for employment with Research Foundation for Mental Hygiene, Inc.
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Malpractice Payment Report Form For Insurance Companies
PDF template
Official form for reporting medical malpractice judgments and settlements in Alabama by insurance companies and healthcare entities.
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MAMFA Studio Programs Application Form
PDF template
Application form for admission to graduate art programs at California State University, Fullerton with various concentration options.
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MAMI Assessment Form
PDF template
A comprehensive medical assessment form for infants, evaluating health status, growth, and potential risks.
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Managed Care Referral Form
PDF template
A medical referral form for Blue Cross and Blue Shield of Minnesota managed care patients requiring specialist or additional medical services.
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Medical History Form
PDF template
A comprehensive medical form for camp participants to document health information, emergency contacts, and treatment authorization.
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Extended Health Care Claim
PDF template
Insurance claim form for submitting extended healthcare expenses to Manufacturers Life Insurance Company group benefits plan.
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Medical Assistant Physical Examination Form
PDF template
A comprehensive health screening form for medical assistant students, documenting physical health status and potential medical conditions.
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PHYSICAL EXAMINATION FORM 2019 2020 Academic Year
PDF template
A comprehensive medical examination form for students participating in clinical practice settings at the University of Michigan School of Nursing.
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Department Of State Academic Exchanges Participant Medical History And Examination Form
PDF template
A medical form required for participants in U.S. Department of State educational exchange programs to confirm health status and obtain medical clearance.
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Student Physical Exam Information Form
PDF template
Comprehensive health form for collecting student physical examination details and medical history for college enrollment.
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PhotoVideo Marketing And Media Release Form
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Legal document granting permission for Southland Therapy Services to use photographs, video images, and statements for marketing purposes.
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Marketplace Medical Claim Form
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A comprehensive form for submitting medical insurance claims, including subscriber and patient information, accident details, and coverage information.
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Miami County Marlins Swim Team Emergency Medical Authorization Form
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A form allowing parents to authorize emergency medical treatment for children during swim team activities when parents cannot be reached.
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Parental Consent Form
PDF template
A legal document for parental consent when a minor (aged 16-18) seeks to obtain a marriage license in South Dakota.
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MAP Marshall Adventure Program Commitment To Excellence Media Release Form
PDF template
A form outlining participant expectations and media usage consent for Marshall University's Adventure Program activities.
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Consent To Release Educational Records For Medicaid Billing
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A consent form allowing school district to release student educational records for Medicaid reimbursement of special education services.
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Maryland Youth Camp Incident Report Form
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Official form for documenting incidents, injuries, or illnesses occurring at youth camps in Maryland.
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Patient Intake Form
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Comprehensive medical history form for collecting patient personal and health information for Dr. Maria Suurna's medical practice.
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MASDS Waiver Form
PDF template
A form for students in the Master of Applied Statistics & Data Science program to request waiving core courses based on equivalent prior coursework.
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MASH North Arkansas Regional Medical Center APPLICATION CHECKLIST
PDF template
Comprehensive checklist for student application to medical shadowing program with required forms and documentation.
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Mass Casualty Event O Red Cell Inventory Form
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A form for hospitals to assess and manage red blood cell inventory during a mass casualty event, calculating needed blood units.
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Craniofacial Fellowship Application Form
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Comprehensive application form for medical professionals seeking a craniofacial fellowship, collecting detailed personal and professional information.
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Master Medical Form
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Comprehensive medical form for camp participation, focusing on epilepsy and health conditions for Epilepsy Alliance Ohio's Camp Flame Catcher/Camp for Champs.
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New Student CHECK LIST
PDF template
Comprehensive checklist for incoming students at Rutgers covering email activation, ID, medical forms, and document submission requirements.
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NORTH DAVIS PREPARATORY ACADEMY (NDPA) STUDENT MEDICAL FORM
PDF template
A comprehensive medical form for collecting student health information and emergency contact details for North Davis Preparatory Academy.
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Adult TB Risk Assessment And Screening Form
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A comprehensive screening form to assess an individual's risk factors and symptoms related to tuberculosis (TB) infection.
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Material Damage Proposal
PDF template
Insurance proposal form for documenting property details, insurance requirements, and risk assessment for material damage coverage.
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Bryan College Dual Enrollment Math ACT Waiver Form
PDF template
A form allowing students to enroll in college-level math courses despite not meeting standard ACT math prerequisites
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Incident Report Form Template
PDF template
A standardized form for documenting and reporting incidents involving individuals, with details about the event, participants, and follow-up actions.
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Pregnancy Booking Form For Harrogate Hospital
PDF template
Comprehensive medical intake form for pregnant patients seeking care at Harrogate Hospital, collecting personal, medical, and lifestyle information.
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Cardiac Requisition
PDF template
Medical form for requesting cardiac diagnostic imaging and consultation, including patient history and risk factors assessment
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Sharp Health Plan Reimbursement Request Form
PDF template
A form for submitting medical expense reimbursement claims to Sharp Health Plan with detailed instructions and personal information fields.
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MC 20 (617) WAIVERSUSPENSION OF FEES AND COSTS (AFFIDAVIT AND ORDER)
PDF template
A legal form for requesting waiver or suspension of court fees based on financial hardship or public assistance status.
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Donald C. Balfour Alumni Association Award For Meritorious Research 2024 Nomination
PDF template
Nomination form for recognizing exceptional research contributions by early-career medical researchers at Mayo Clinic.
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Edward C. Kendall Alumni Association Award For Meritorious Research 2024 Nomination
PDF template
Nomination form for the Edward C. Kendall Alumni Association Award recognizing outstanding research accomplishments by early-career medical and doctoral researchers.
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Contribution Form
PDF template
A form for making financial contributions to Mayo Clinic for various programs and purposes.
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Duke Gastroenterology Referral Form
PDF template
A medical referral form for gastroenterology services at Duke Health, used by healthcare providers to request clinic evaluations and procedures.
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Proteomics Core Service Request
PDF template
A research service request form for proteomics analysis and sample submissions at Mayo Foundation.
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Mayo Clinic Administrative Fellowship Application Form
PDF template
Fellowship application form for graduate students seeking leadership roles in healthcare at Mayo Clinic across various programs and settings.
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Human Subjects Research Project Consent Form Checklist
PDF template
Checklist for ensuring compliance with informed consent requirements for human subjects research at Monroe Community College.
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Graduate Waiver Form
PDF template
A form for graduate students to request course fee waivers at Morton College with options for different credit hour levels.
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MCH 213G School Health Entrance Form Instructions
PDF template
A comprehensive form for documenting student health information, immunization status, and physical examination required for school entry in Virginia.
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Graduate Medical Education Disciplinary Action Form
PDF template
Form documenting academic deficiencies, misconduct, and potential disciplinary actions for medical residents.
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LAB REQUISITION FORM
PDF template
A laboratory test request form listing multiple lab test options and medical facility locations in Southern California.
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MCO Discharge Form
PDF template
A comprehensive discharge form for behavioral health and recovery services tracking client status, diagnoses, and referral information.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical intake form collecting patient personal, medical, social, and health history details.
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VISION EVALUATION REPORT (Form MCSA 5871)
PDF template
A medical form for evaluating the vision capabilities of commercial motor vehicle drivers to determine physical qualification standards.
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VISION EVALUATION REPORT (Form MCSA 5871)
PDF template
A medical form for evaluating the vision capabilities of commercial motor vehicle drivers to determine physical qualification standards.
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Medical Expense Claim Form
PDF template
A form for employees to claim medical expense reimbursements through their flexible spending account with detailed claim submission instructions.
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Mount Sinai Adolescent School Based Health Center Parental Consent Form
PDF template
Parental consent form for students to use school-based health center services at Manhattan area schools.
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Name Based Criminal History Record Information ConsentInquiry Form
PDF template
A consent form for conducting criminal history background checks for various employment and service purposes in Georgia.
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Release And Indemnification Agreement
PDF template
A legal document releasing The Medical College of Wisconsin from liability for potential injuries or damages during an unspecified activity involving a minor participant.
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Media Release Parental Consent Form
PDF template
A form allowing parental consent for students to be photographed, videotaped, or interviewed at school events for media use.
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CLAIM FORM PART A
PDF template
A comprehensive form for filing health insurance claims, designed to collect detailed patient and insurance information.
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Meal Break Waiver Form
PDF template
A form allowing employees to voluntarily waive meal breaks under specific California labor law conditions
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Endorser Consent Form For Ballot Measure
PDF template
Form for individuals to consent to being named as an endorser for a ballot measure in the City of Hayward Special Municipal Election.
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MEDICAL BENEFITS SUBSCRIBER CLAIM FORM
PDF template
A comprehensive medical insurance claim form for submitting healthcare expense reimbursement and insurance details.
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Consent For Administration Of Health Treatment AndOr Medication At School
PDF template
A form for obtaining parental and physician consent to administer medical treatments or medications to students during school hours.
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Emergency Medicine Medical Education Fellowship Application
PDF template
Application form for medical professionals seeking an emergency medicine medical education fellowship at the Medical University of South Carolina.
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NWC EMSS Non Transport Vehicle Inspection Instructions
PDF template
Instructions for completing Illinois Department of Public Health (IDPH) non-transport vehicle inspection forms for emergency medical services vehicles
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MEDEVAC REQUEST FORM
PDF template
A standardized form for requesting medical evacuation with detailed instructions for field reporting of patient and site conditions.
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MEDEX ACADEMY Consent Form
PDF template
Consent form for students 21 years and older participating in MedEx Academy, covering medical treatment, liability release, and media permissions.
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ParentalGuardian Consent Form
PDF template
A consent form for parents/guardians to authorize student participation in the MedEx Academy program, including medical treatment and promotional permissions.
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Medex Subscriber Claim Form
PDF template
A claim submission form for medical services processed by Blue Cross Blue Shield of Massachusetts for Medex subscribers.
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Student Medical Form
PDF template
Comprehensive medical form collecting student health details, emergency contact information, and medical history for school purposes.
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Media Release Form
PDF template
A form granting permission to use photos or videos of a child taken during a 4-H event for various media and marketing purposes.
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Media Release Form
PDF template
A comprehensive release form for participation in university programs, covering media usage and liability waiver for participants and guardians.
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Media Release Form
PDF template
A consent form authorizing the use of audio, photographs, videotape, or film of a child for publicity and marketing purposes.
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Medical Release Form
PDF template
A form authorizing the release of medical treatment information to specified facilities or individuals.
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Media Release Form
PDF template
Legal document granting permission for a school to use a child's photographs and recordings for marketing and social media purposes.
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Media Release Form
PDF template
A form allowing parents to consent or decline permission for their children to be photographed or recorded during school activities.
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Media Recording And Performance Release Form
PDF template
A legal document granting State University of New York at Fredonia permission to record, distribute, and use an artist's performance media and likeness.
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Media Release Form 16
PDF template
A form allowing individuals 16 and older to grant permission for their image to be used in marketing materials by Henry Ford College.
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Adult Media Release
PDF template
A consent form allowing media coverage of participants in the Citizen Police Academy program.
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Media Release Form
PDF template
Legal document granting permission to use an individual's or child's photo, video, or likeness for promotional purposes by the Optometric Foundation of North Dakota.
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Media Release Form
PDF template
A consent form for parents/guardians to authorize the use of swim team photos, statistics, and contact information for team communications and media purposes.
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Media Release Form
PDF template
A form granting permission for the Special Education Service Agency (SESA) to use an individual's or minor's media materials for various publications and communications.
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MEDIA RELEASE FORM
PDF template
Legal form granting permission for student photography and media usage by the Catholic Archdiocese of Atlanta.
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Student Media Release Form
PDF template
A form allowing parents/guardians to consent or deny permission for student media publication and directory listing.
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Media Release Consent Form
PDF template
Consent form allowing Sport for Life Society to use participant's interviews, recordings, photographs, and videos for organizational purposes.
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Media RecordingUsage Release
PDF template
A legal document granting West Virginia University permission to record, photograph, and use an individual's image for various media purposes.
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Media Release Form
PDF template
A form granting permission for the College to use photos and videos of individuals for promotional purposes.
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2021 2022 Media Release Form
PDF template
A legal form granting permission for The Arc Allegany-Steuben to use an individual's image, name, and personal testimony for promotional purposes.
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MEDIA RELEASE FORM
PDF template
A consent form for photographing, interviewing, and using an individual's media content for non-profit purposes.
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Media Release Form
PDF template
Legal document granting permission for the State of Kansas to use an individual's image across various media platforms.
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Media Release Opt Out Form
PDF template
A form allowing faculty, staff, students, and parents to opt out of media usage and promotional materials by the college.
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Media Release Form
PDF template
A legal document granting permission to record, use, and distribute images or recordings of a student for educational and promotional purposes.
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Media Release Form
PDF template
A form granting permission for the College to use photographs and video images of individuals for promotional purposes.
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Media Release Form
PDF template
A form granting permission for Hood College to use an individual's photographs, likeness, stories, artwork, or recordings for promotional purposes.
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Media Release Form 2022 2023 Season
PDF template
A consent form allowing the Bismarck Mandan Symphony Orchestra to use an individual's image and name for media and promotional purposes.
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Media Release Form
PDF template
Legal document granting permission to record and use an individual's image, voice, or performance for educational and promotional purposes.
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MEDIA RELEASE FORM
PDF template
A legal document authorizing Oregon Health & Science University to use an individual's image, likeness, and recordings for various media and communication purposes.
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LULAC Adelante America Program Media Release Form
PDF template
A consent form allowing LULAC and Verizon to use participant images and statements for marketing and promotional purposes.
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MEDIA RELEASE FORM
PDF template
Legal document granting permission to use images, video, and biographical information for media purposes by the American Humane Association.
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Media Authorization Release Form Community
PDF template
A legal document authorizing Johnson County Community College to use an individual's image, voice, and likeness for educational and promotional purposes.
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Media Release Form
PDF template
A form granting permission to Literacy Connects to use photographs, videos, and written materials for non-commercial promotional purposes.
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Faculty Staff Media Release Form
PDF template
A consent form allowing Southern Utah University to use media and information from international travelers for various communications and marketing purposes.
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Media Release Opt Out Form
PDF template
Form allowing faculty, staff, and students to opt out of media usage for promotional purposes by College of The Albemarle.
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Media Release Form
PDF template
A form outlining photo and media documentation consent for students at Prairie Sky School, including guidelines for photo usage in various school media channels.
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Media Release Form
PDF template
A form granting or denying permission for Qalipu First Nation to use participant images and media for various productions.
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Media Release Form For Students
PDF template
A form for parents/guardians to grant or deny permission for their child's media representation in school-related communications and events.
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Media Release Form
PDF template
A consent form allowing Northside ISD to use a student's image and name for publicity purposes related to intramural sports.
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Media Authorization And Release
PDF template
A consent form granting Catholic Charities Community Services permission to use photographs, videos, and images of participants and their children for various purposes.
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LULAC Latina Entrepreneur Academy Media Release Form
PDF template
A consent form allowing LULAC and Coca-Cola Foundation to use participant images and statements for marketing purposes.
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Media Release Form Mental Health Awareness Patch
PDF template
A consent form allowing the International Bipolar Foundation to use photos for mental health awareness materials and social media.
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Media, Photo Video Release Form
PDF template
Legal document granting Wright State University rights to use photographs and recordings of a minor participant in university media and promotional materials.
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Media Release Form
PDF template
A legal document granting Nevada Volunteers permission to use a volunteer's name, image, and likeness for promotional purposes without compensation.
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Media Release Form
PDF template
Legal document authorizing University Libraries to record, use, and distribute an individual's likeness and performance across various media platforms.
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Media Release Form
PDF template
A consent form allowing or denying permission for Girl Scout members to be photographed, interviewed, or videotaped for promotional materials.
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Temple Beth Torah Media Release Form
PDF template
A consent form allowing Temple Beth Torah to use photographs and videos of children for educational and promotional purposes.
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Media Release Form
PDF template
A form granting Anne Arundel County Public Schools permission to use photographs, images, videos, and voice recordings for educational purposes.
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Media Release Form For Photographs, Videos, And Other Recordings
PDF template
A consent form allowing Etiwanda School District to use a child's photographs, videos, recordings, and interview content for educational and promotional purposes.
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Media Release Form
PDF template
Legal document authorizing the use of participant's likeness and information for educational and marketing purposes during a study abroad program.
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Media Release Form
PDF template
A form allowing parents/guardians to grant or deny permission for using a swimmer's photos, statistics, and contact information for team communication and media purposes.
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Macalester College Media Release Form
PDF template
A form authorizing Macalester College to record, archive, and use an individual's presentation or event materials for academic and non-commercial purposes.
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MEDIA RELEASE FORM
PDF template
A legal form granting permission for a school to use a child's image in various publications and media.
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MEDIA RELEASE FORM
PDF template
Legal document granting New York University permission to use photographs, videos, and audio recordings of an individual for promotional purposes.
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Media Release Form For Parent And Minor
PDF template
A form granting permission for Henry Ford College to use photos, videos, and digital representations of a minor for marketing purposes.
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Media Release Form
PDF template
A consent form allowing Keystone Mission to use an individual's photos, recordings, and personal story for media and fundraising purposes.
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Sigma Tau Delta Media Release Form
PDF template
A legal release form authorizing Sigma Tau Delta to use participant's photographic, video, and audio recordings for organizational purposes.
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Media Release Form
PDF template
A legal document granting permission for the Department of Financial Protection and Innovation to use an individual's image across various media platforms.
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Ventura County Library Foundation Media Release Form
PDF template
A legal document granting the Ventura County Library Foundation permission to use photographs, videos, and audio of individuals for various purposes.
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Media Release Form
PDF template
A consent form allowing National PTA and TikTok to photograph, record, and use images of individuals and their families for various purposes.
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Media Release Form
PDF template
Official document granting the Idaho Transportation Department permission to use agency images for various media and publication purposes.
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Medicaid Form Order
PDF template
A form for ordering various Medicaid-related medical and administrative forms from Montana Medicaid.
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NJCAA Medical Evaluation Form
PDF template
Comprehensive medical history and evaluation form for student athletes to assess their health and fitness for sports participation.
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Medical History Form
PDF template
Instructions and form for students to provide medical history, immunization records, and insurance information for campus health services.
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NAUI Medical Form
PDF template
Medical screening form for diving training applicants to assess potential health contraindications for SCUBA activities.
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Medical Release Form For 4 H Youth Adults
PDF template
A comprehensive medical release and health information form for 4-H program participants, collecting emergency contact, medical history, and treatment authorization details.
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COLTS YOUTH ORGANIZATION MEDICAL RELEASE FORM
PDF template
A comprehensive medical history and health disclosure form for Colts Youth Organization volunteers and staff members.
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Working Environment, Medical Approval And Fit Testing Forms
PDF template
Comprehensive form for assessing employee fitness for respirator use, including work environment evaluation and medical approval.
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Medical Assessment Form
PDF template
A medical form used to assess disability status for subsidized child care program eligibility.
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Studentsafe Inbound Medical Risk Assessment Form
PDF template
Insurance form for international students to disclose pre-existing medical conditions for coverage under Studentsafe insurance policy.
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USA Ultimate Medical Authorization Form
PDF template
A medical authorization form for parents/guardians to provide emergency treatment consent for children participating in Ultimate activities.
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Subscriber Medical Claim Form
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient and insurance details.
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Medical CertificationInquiry Form
PDF template
A form used to assess an employee's medical condition and potential workplace accommodations by requesting medical professional certification of job function limitations.
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Medical Plan CHANGE Form
PDF template
Comprehensive guide for completing and submitting a medical plan change form with detailed documentation requirements.
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H.P.T.R.6 MEDICAL CHARGES REIMBURSEMENT FORM
PDF template
A comprehensive form for employees to claim reimbursement of medical expenses with detailed documentation and verification requirements.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive form for submitting medical insurance claims, capturing patient and treatment details for reimbursement.
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Medical Claim Form
PDF template
Insurance claim form for submitting medical expenses and travel-related healthcare claims with multiple payment options.
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Medical Claim Form
PDF template
Form for submitting out-of-network health care claims to UnitedHealthcare for reimbursement of eligible medical services.
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Medical Claim Form
PDF template
A form for submitting medical insurance claims with patient and insurance details for reimbursement processing.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive insurance claim form for submitting medical treatment claims, capturing patient and treatment details.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive medical insurance claim form for submitting healthcare treatment reimbursement or payment requests.
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Claim Form To Pay InsuredSubscriber
PDF template
A comprehensive form for submitting medical insurance claims with details about patient, treatment, and coverage information.
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Medical Clearance Form
PDF template
A comprehensive medical form for incoming students requiring medical history, immunization records, TB screening, and insurance information.
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Medication Consent Form
PDF template
Form for parents/guardians to provide consent for medication administration to children in child care settings
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Medication Consent Form
PDF template
A form for parents/guardians to authorize medication administration for children in child care settings.
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Fondren Foundation Special Patient Clinic Dental Referral Form
PDF template
A medical referral form for patients with complex medical conditions seeking dental screening and assessment at UTHealth Houston School of Dentistry's Special Patient Clinic.
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Direct Member Reimbursement Form
PDF template
A form for AvMed members to request reimbursement for covered medical services by submitting documentation and details of treatment.
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Medical Emergency Contact Form For StudyInternTeach Away
PDF template
A medical contact and history form for students participating in study, internship, or teaching programs abroad.
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Medical Plan Enrollment Form
PDF template
Comprehensive form for enrolling in medical coverage, changing plans, or adding/dropping dependents for ACERA members.
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Easterseals Wisconsin Camps Medical Examination Form
PDF template
Medical form for documenting a camper's health status, medical history, and immunization records for participation in Easterseals Wisconsin Camps.
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Medical Examination Report For Commercial Driver Fitness Determination
PDF template
Comprehensive medical assessment form for commercial drivers to determine fitness for driving based on health status and medical history.
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Form MCSA 5875 Medical Examination Report Form
PDF template
Medical examination form for commercial driver license (CDL) applicants to assess medical fitness for driving.
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Medical History Form
PDF template
A comprehensive medical history form for assessing health status and potential exercise risks, specifically for Central Oregon Community College's Exercise Physiology Lab.
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Seoul International School Authorization For Medical Procedure Student Medical History Health Fo
PDF template
Medical authorization and health history document for students at Seoul International School, covering emergency care permissions and medical history details.
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ISTEM Summer Program Medical Form
PDF template
Medical form for students attending the UCF iSTEM Summer Program, collecting personal, emergency, and health information.
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Medical Information Form
PDF template
A comprehensive medical form for participants in Andes Climb and Atacama Leadership Ventures, requiring full medical disclosure and physician examination.
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COLTS DRUM BUGLE CORPS MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for student members of a drum and bugle corps, covering personal health history and potential medical conditions.
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MEDICAL FORM PERSONAL INFORMATION
PDF template
A confidential form to collect medical and personal details for kayaking tour participants to ensure safety and appropriate instruction.
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Medical Information Form
PDF template
A detailed medical form capturing patient and treatment information for cancer patients seeking support from Angel Foundation.
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Emergency Contact And Medical Information
PDF template
Form for collecting medical information, emergency contacts, and medical authorization for a child during a specific event or period.
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Medical Form
PDF template
Comprehensive medical history and health information form for students at St. Mary's College.
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Medical Form
PDF template
Form for documenting medical life support needs and service requirements for utility account holders with medical conditions.
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Upward Bound Medical Information Release Form
PDF template
A comprehensive medical form for students in the Ohio State ATI Upward Bound Program that provides medical information, emergency contact details, and parental consent for medical treatment.
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Medical Consent Form
PDF template
Comprehensive medical form for collecting a child's health history, emergency contact information, and medication permissions.
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New York State Science Olympiad Medical Form
PDF template
Medical form for participants and alternates in Science Olympiad tournament, requiring comprehensive health and emergency contact information.
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Injuries Resolution Board Medical Assessment Form (Form B)
PDF template
A standardized medical report template for documenting injuries and medical assessments for personal injury compensation claims in Ireland.
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Medical Information Form
PDF template
Medical information and consent form for student enrollment, including health details, allergies, and medication permissions
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Medication Emergency Treatment Authorization For Participants In Programs Involving Minors
PDF template
A comprehensive medical authorization form for parents/guardians to provide health and emergency contact information for children participating in Boston College youth programs.
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Department Of State Academic Exchanges Participant Medical History And Examination Form
PDF template
A comprehensive medical history form required for participants in U.S. Department of State educational exchange programs to confirm health status and obtain medical clearance.
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Medical Form
PDF template
A comprehensive medical form for collecting student health information, emergency contacts, and parental consent for medical treatment.
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Adult Confidential Medical Record
PDF template
A comprehensive medical form for collecting personal health information and emergency contact details for program participation.
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Diving Medical History Form
PDF template
A comprehensive medical screening form for applicant-divers to assess their fitness for diving activities and potential health risks.
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MEDICAL FORM SELF REPORT
PDF template
A comprehensive medical self-report form for patients to document their medical history and current health conditions.
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Camp Mak A Dream Summer Staff Medical Information Form 2023
PDF template
Comprehensive medical information form for summer camp staff to document health history, immunizations, medical conditions, and emergency contacts.
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Camp Mak A Dream Summer Staff Medical Information Form 2024
PDF template
Comprehensive medical history and health information form for summer camp staff members, collecting details about medical conditions, immunizations, and emergency contacts.
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Medical Form
PDF template
A comprehensive medical information form for students to provide health details, emergency contact information, and medical treatment permissions.
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Messiah University Young Writers Workshop Medical Form
PDF template
A medical form for participants of a youth writing workshop, capturing emergency contact, medical history, and medication information.
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Medical History Form
PDF template
Comprehensive medical history questionnaire for patient medical assessment, including health conditions, personal details, and examination data.
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Cottonwood Crossing Summer Institute Health Insurance And Medical History Form
PDF template
A form collecting student health information, insurance details, and medical emergency consent for a summer program participation.
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Medical History And Permission Form For Treatment
PDF template
Medical authorization and medication details form for parents of summer program participants to provide medical treatment consent and medication information.
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MEDICAL HISTORY
PDF template
Comprehensive medical history form covering personal health, medical conditions, medications, allergies, lifestyle, and previous medical procedures.
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NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for new patients to document current medications, health problems, and medical conditions.
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MEDICAL HISTORY FORM
PDF template
A comprehensive form for collecting patient personal and insurance information for medical purposes.
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DENTALMEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient dental and medical history information for a student dental hygiene clinic.
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MEDICAL HISTORY FORM
PDF template
Comprehensive form for collecting patient personal and insurance information for medical purposes.
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Sport Club Medical History Form
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Medical history and health screening form for participants in sport club activities at CSU Recreation Services.
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MEDICAL HISTORY FORM
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Comprehensive medical history and personal health information form for students at Vanguard University's Health Center.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient personal details, health conditions, and contact information.
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Medical History Form
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A comprehensive medical form documenting a patient's medical condition and impairments for service dog placement evaluation.
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Medical History, Examination, And Fitness For Training
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A medical history and examination form for law enforcement officer training applicants to determine fitness for training at the Criminal Justice Academy.
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Medical History Form
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A comprehensive form for collecting patient medical history, current health status, and therapy-related information.
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Patient Questionnaire Medical History Form
PDF template
Comprehensive medical intake form for patient history and current medical condition assessment, used in healthcare settings.
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Student Health History Form
PDF template
Comprehensive health history form for students enrolling at Watertown campus, collecting personal and family medical information.
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Medical History Form
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Comprehensive medical intake form for capturing patient personal information, medical history, and contact details for a dermatology practice.
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PARTICIPANT MEDICAL HISTORY FORM
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Comprehensive medical history form for participant health information, emergency contacts, and authorization details for a camp or program.
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Medical History
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, and lifestyle details.
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Medical History
PDF template
Detailed medical history document capturing patient health information across multiple body systems and medical conditions.
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Health History Form
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A comprehensive medical history form for students to document their personal health information and medical conditions.
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Medical History Form (For Immigration Examination)
PDF template
Comprehensive medical history form for immigration purposes, covering various health conditions and medical background
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Medical History Form
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Comprehensive medical form for collecting patient's personal and family medical history, including past diagnoses, allergies, and health conditions.
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Medical History Form
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Comprehensive medical form for collecting patient's personal health information, medical history, current symptoms, and social history.
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Health History Form
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Comprehensive medical history form for patients to provide detailed health information prior to a medical appointment.
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Medical History Form
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Comprehensive medical form for collecting patient personal information, medical history, current health status, and pain assessment details.
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Medical History Form
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Comprehensive medical history form for collecting patient personal information, medical background, lifestyle details, and current medications.
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UVM OUTING CLUB MEDICAL HISTORY FORM
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Comprehensive medical information form for University of Vermont Outing Club participants to assess health status and potential risks during outdoor activities.
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Medical History Form
PDF template
Comprehensive medical history form for dental patients to provide health background and current medical status.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form focusing on patient's hearing health, ear conditions, and communication difficulties.
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Medical History Form
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Comprehensive medical history and health status documentation form for patients at Freedom House for Women
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Medical History Form
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Comprehensive medical history form collecting patient health information, current treatments, medications, and past medical conditions.
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SLEEP STUDIES PERSONAL HISTORY FORM
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Comprehensive medical history form for patients undergoing sleep studies, collecting personal health information and symptoms.
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Personal Medical History
PDF template
Comprehensive form for collecting patient's personal medical history, surgical history, allergies, and family medical background.
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Intake And History Form
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Comprehensive medical intake form for collecting patient's personal information, current health concerns, medical history, and past treatments.
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MEDICAL HISTORY FORM
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A comprehensive form for collecting detailed medical history information about a child, including birth history, past medical history, and family medical history.
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Fontbonne University Resident Medical Information
PDF template
Comprehensive medical information and immunization requirements for new resident students at Fontbonne University.
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Medical History Form
PDF template
Comprehensive medical history form for dermatology patients collecting personal health information, medical background, and contact details.
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Adult Medical History Form
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Comprehensive medical history form for collecting patient health information, medical conditions, surgical history, and current medications.
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Andrew College Medical History Form
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A comprehensive medical history form for student athletes at Andrew College, collecting personal health information and medical background details.
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Medical History And Physical Examination Form
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Comprehensive medical history and physical examination form for students, collecting personal health information and examination results.
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Medical Incident Report
PDF template
A comprehensive form for documenting medical incidents and patient health status during flight.
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University Of Alaska Southeast Outdoor Education Medical Information Questionnaire
PDF template
A confidential medical form for participants in University of Alaska Southeast outdoor education courses, collecting personal and medical details for safety purposes.
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Medical Inquiry Form In Response To A Disability Accommodation Request
PDF template
A form used by California State University, East Bay to assess an employee's disability status and potential reasonable accommodations under the ADA.
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Medical Inquiry Form In Response To A Reasonable Accommodation Request
PDF template
A medical form used to evaluate an employee's disability status and potential workplace accommodations under ADAAA guidelines.
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Medical Inquiry Form In Response To An Exemption Request To In Person Work For Medical Reasons
PDF template
A medical form used to assess an employee's medical conditions and potential limitations for workplace accommodations or remote work exemptions.
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Medical Inquiry Form In Response To An Accommodation Request
PDF template
Medical form for healthcare providers to assess an employee's disability status and potential workplace accommodations under the Americans with Disabilities Act (ADA).
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Medical Inquiry Form In Response To An Accommodation Request
PDF template
A medical form used to evaluate an employee's disability status and potential workplace accommodations under the Americans with Disabilities Act (ADA).
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Medical Inquiry Form In Response To A Reasonable Accommodation Request
PDF template
A form used to assess an employee's disability status and potential need for reasonable accommodations under the ADAAA.
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Medical Inquiry Form For Employee ADA Accommodation Request
PDF template
Form for healthcare providers to document medical information related to employee accommodation requests under ADA guidelines.
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MEDICAL INQUIRY FORM
PDF template
A form authorizing release of medical information for evaluating workplace disability accommodations and job function capabilities.
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MEDICAL INQUIRY FORM RESPONSIVE TO ACCOMMODATION REQUEST
PDF template
A form for employees to request medical accommodations by authorizing their healthcare provider to release relevant medical information to their employer.
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Medical Inquiry Form In Response To An Employee Accommodation Request
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A medical form used to assess an employee's disability status and potential workplace accommodations at Portland Community College.
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ORNL Physical Examination Instructions
PDF template
Instructions for new hires at Oak Ridge National Laboratory (ORNL) regarding medical examination preparation and required documentation.
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University Health Center Medical Insurance Form
PDF template
A form for collecting student and insurance policy details for medical services at a university health center.
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PATIENT INTAKE FORM PPOMEDICARESELF PAY
PDF template
Comprehensive patient registration form collecting personal, insurance, and financial information for medical services.
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Medical Marijuana Consent Form
PDF template
A comprehensive consent form for patients seeking medical marijuana, explaining legal, FDA, and health considerations.
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Medical Panel Transfer Request Form
PDF template
A form for healthcare practices to transfer between medical panels with required practice and Designated Provider Representative (DPR) information.
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Campus Guest Medical Release Form
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Medical authorization form for campus visitors allowing emergency medical treatment and documenting health information.
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Medical Release FormPermission To Treat
PDF template
A comprehensive medical form for collecting personal, emergency contact, insurance, and medical information with treatment authorization.
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Medical Power Of Attorney
PDF template
A legal document that allows an individual to designate an agent to make medical decisions on their behalf when they are no longer able to do so.
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Medical Practitioner Authorization Form (MPAF) For SBAP Services
PDF template
Authorization form for medical practitioners to approve health-related services for students in the School-Based Access Program (SBAP)
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Pre Authorization Form For Medical Procedures
PDF template
A form for pre-authorizing medical procedures for state employees with work-related injuries
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MEDICAL HISTORY QUESTIONNAIRE ILEA Students
PDF template
A comprehensive medical history form for students to assess health status and readiness for training, ensuring confidentiality and emergency preparedness.
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MEDICAL HISTORY QUESTIONNAIRE ILEA Students
PDF template
A comprehensive medical history form for students to assess health status and readiness for training, ensuring medical confidentiality.
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Medical Release Form
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A form authorizing the release of medical records from one healthcare provider to another, with patient consent.
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Medical Release Form
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Authorization for releasing protected health information to a designated company with patient consent.
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PI 118 Medical Referral Of Restricted Participant
PDF template
Official form for medical provider referrals for restricted Missouri Medicaid participants to document medically necessary service transfers.
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H.P.T.R. 6 MEDICAL CHARGES REIMBURSEMENT FORM
PDF template
A form for treasury employees to claim reimbursement of medical expenses incurred for treatment of themselves or dependents.
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Peace Corps Invitee Medical Reimbursement Form
PDF template
A form for Peace Corps invitees to claim reimbursement for medical expenses not covered by primary health insurance.
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Medical Reimbursement Form
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Form for seeking reimbursement of medical expenses in a domestic relations case, detailing documentation requirements and payment process.
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MEDICAL RELEASE FORM 2024 2025 Lifetime Fitness Program
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A medical release form for participants in the University of Illinois at Urbana-Champaign Lifetime Fitness Program, requiring physician assessment of medical conditions.
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Virginia Military Institute Medical Release Form
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Medical form certifying an applicant's physical and mental fitness for the rigorous Virginia Military Institute cadet program.
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Medical Release Form
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Medical authorization form for children participating in Kinetic Kids sports and recreation programs, allowing parents to specify health conditions and activity clearances.
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Medical Release And Accommodations Related To Injury Or Illness
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A document detailing the process for students with medical conditions to request accommodations in nursing school classrooms and clinical settings.
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Medical Release Form
PDF template
A form granting permission to release confidential medical information to the Virginia Tech Adult Day Care Center.
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Authorization To Release Medical Information Form
PDF template
A form authorizing the release of medical records and personal health information between healthcare providers or entities.
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Williamsport Volunteer Fire Emergency Services Inc. Medical Release Form
PDF template
A form authorizing the release of medical information from Williamsport Volunteer Fire Emergency Medical Services Inc.
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Authorization For Disclosure Of Health Information
PDF template
A form authorizing the release of personal health information with consent and understanding of privacy rights.
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WASHINGTON YOUTH SOCCER PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
PDF template
A medical consent and release form for youth soccer players, capturing emergency contact, medical history, and parental consent for participation.
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Little League Baseball And Softball Medical Release
PDF template
Medical authorization form for youth baseball and softball players, allowing emergency medical treatment and capturing critical health information.
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Medical Liability Release Form
PDF template
A medical liability release form for HOSA delegates, parents, and guardians to attend conferences and experiences during the 2019-2020 academic year.
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IM, Inc. ETEAM MEDICAL RELEASE FORM
PDF template
A comprehensive medical information and emergency contact form for gathering participant health details and insurance information.
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Medical Release Form
PDF template
A medical form authorizing camp staff to administer prescribed medications to a child during camp hours.
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Medical Liability Release Form
PDF template
A liability release form for HOSA delegates, parents/guardians, guests, and advisors to participate in conferences and experiences.
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Saint John Fisher ConfirmationYouth Ministry HealthMedical Release Form
PDF template
A medical release and authorization form for youth ministry participants, allowing consent for medical treatment and documenting health information.
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Medical Release Form
PDF template
A legal document authorizing the release of patient's medical records and health information to designated individuals or organizations.
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Medical Release Form
PDF template
Medical release and health information form for adult participants in Eagle Bluff activities, requiring personal and medical details.
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Medical Release Form ADA 3 Pages
PDF template
A medical authorization form for students seeking disability accommodations at Missouri Valley College, allowing healthcare providers to share medical information with college personnel.
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Medical Record Release Form
PDF template
A form authorizing the release of confidential medical records to Complete Dermatology medical offices
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Medical Release Form
PDF template
A form to authorize the release of patient medical information for insurance claim processing.
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HIPAA Privacy Authorization Form
PDF template
Authorization form for releasing protected health information for St. John Fisher College students, complying with HIPAA regulations.
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Honors Symposium Medical Release Form
PDF template
Medical release and health history form for students participating in the Harding University Honors Symposium program
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Medical Release Form
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A medical release form for parents or legal guardians to provide health information and emergency contact details for a child attending Music Camp at Southwestern Baptist Theological Seminary.
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Christ In Youth Discipline, Liability Medical Release Form
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A comprehensive release form for participants of Christ In Youth events covering discipline, liability, and medical information.
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Medical Release Form
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A medical consent form for parents/guardians to authorize medical treatment for a minor in their absence.
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MEDICAL LIABILITY RELEASE
PDF template
Comprehensive medical and liability release form for camp registration, including health information, emergency contacts, and photo/transportation permissions.
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RELEASE FROM LIABILTY And MEDICAL CARE
PDF template
A form allowing individuals to decline medical assistance and release the college from liability for such refusal.
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Medical Release Form
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A medical consent and emergency contact form for students participating in SkillsUSA activities, allowing designated personnel to seek medical treatment if necessary.
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Event Medical Release Permission Form
PDF template
A comprehensive medical release and permission form for students participating in church youth events, covering medical history, contact information, and emergency details.
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Medical Release Form
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A form authorizing the release and disclosure of patient health information, including medical records and sensitive health data.
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SPECIFIC AUTHORIZATION TO RELEASE PROTECTED HEALTH INFORMATION MEDICAL RECORDS
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A form authorizing the release or request of medical records with patient consent and acknowledgment of sensitive health information disclosure.
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Authorization For Use And Disclosure Of Medical Information
PDF template
A legal document authorizing healthcare providers to release confidential medical records to a specified facility.
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MEDICAL RELEASE FORM
PDF template
Medical form for seniors to obtain physician approval for exercise program participation at Teaneck Senior Services Center.
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Medical Information Release Form
PDF template
A document authorizing the release of medical or personal information by an individual to a specified entity.
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Little League Baseball And Softball Medical Release
PDF template
Medical authorization form for youth baseball and softball players, providing emergency contact and medical information for team participation.
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Medical Release Form
PDF template
Medical release form for children participating in sports and recreation programs, documenting health status and activity clearance.
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Medical Release Form Treatment Of Minor Child
PDF template
A form granting medical treatment authorization for a minor child in case of emergency, including contact and medical information.
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Medical Release Form
PDF template
A form allowing patients to authorize the transfer of medical records to or from Market Street Dermatology.
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Waal Community Academy Medical Release Form
PDF template
A medical release form for documenting student medical information and emergency contact details, with parental authorization for medical treatment.
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MEDICAL RELEASE FORM
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A legal form authorizing medical treatment for a minor by parent or legal guardian, including medical history and emergency contact information.
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Medical Release Form
PDF template
A legal document authorizing medical treatment for a minor and designating emergency contacts and medical information.
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Youth Junior Volleyball Player Medical Release Form
PDF template
A comprehensive medical release and consent form for youth and junior volleyball players to participate in volleyball activities and competitions.
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FALAB Medical Form
PDF template
Medical examination form for firearm license applicants to assess physical and mental fitness for weapon ownership.
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South Carolina State Guard Medical Service Inquiry
PDF template
A comprehensive medical history inquiry form for South Carolina State Guard members, collecting personal and health-related information.
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IUOE Local 4 Reimbursement Form
PDF template
Medical reimbursement form for IUOE Local 4 members seeking compensation for DOT physical exams, massage therapy, and related services.
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CWS Policy Manual Cross Program Procedures Medical TreatmentMedical Releases
PDF template
Comprehensive policy manual detailing medical treatment procedures, consent forms, and authorization processes for children in child welfare services.
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AUTHORIZATION FOR THE RELEASE OF MEDICAL INFORMATION
PDF template
A form allowing students to authorize the release of medical information to the Office of Accessibility for determining disability service eligibility.
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Pikes Peak Regional Law Enforcement Academy Medical Examination Form
PDF template
Medical certification form for law enforcement trainees to verify physical fitness for academy training and activities.
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Direct Member Reimbursement Request Form
PDF template
A form for Medicare plan members to request reimbursement for dental, eyewear, and hearing aid services.
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Medical Reimbursement Request Form
PDF template
A form used to request reimbursement for medical, dental, vision, hearing, and foreign travel care and supplies from a health insurance plan.
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Plan Selection Form Retiree Supplemental Medical
PDF template
A form for retired Oklahoma State University employees to select supplemental medical insurance plans with Medicare eligibility requirements.
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PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, medical, and insurance information for medical services or therapy referral.
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Medication Authorization Form
PDF template
Official form for obtaining parental and medical permission to administer medication to a child in a care facility in Washington, DC.
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SGLGSAMedicationConsent20100122
PDF template
A form for parents/guardians to authorize medication administration for children in early education and care settings.
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Medication Consent Form
PDF template
A form for parents and practitioners to authorize medication administration for students at school, including prescription and emergency medications.
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Medication Inventory Form
PDF template
A detailed form for tracking medication quantities, dosages, and expiration dates for various medical supplies.
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MEDICAL HISTORY FORM
PDF template
A form for patients to document their current medications and medical history details.
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MEDICATIONS REPORT FORM
PDF template
A detailed form for documenting therapeutic medication administration for horses in a veterinary or racing context.
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Claim Form Instructions
PDF template
Detailed instructions for submitting prescription medication reimbursement claims with specific guidance on documentation requirements.
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PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
PDF template
A comprehensive medical consent and release form for youth soccer participants, covering medical history, emergency contacts, and parental authorization.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and medical history information for a healthcare provider.
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UA Affidavit Authorization For Release Of Information
PDF template
Official affidavit and authorization document for releasing information related to physician licensure application for the Maine Board of Osteopathic Licensure.
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Medical Form Requirements Policy
PDF template
Policy update regarding medical form submission requirements for Rhode Island state pilots and medical certification compliance.
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USE OF CLINICAL MATERIALS CONSENT FORM
PDF template
Consent form for CPE students regarding the use of their clinical materials for certification, peer review, accreditation, and research purposes.
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Medical Provider Inquiry Form In Response To An Accommodation Request
PDF template
A form for medical providers to provide details about an employee's medical limitations for workplace accommodation purposes.
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MIT Student Medical Report Form 20242025
PDF template
Medical report form for new and returning MIT students requiring health documentation, immunization records, and medical screening information.
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Chronic Medicine Benefit Application
PDF template
A medical form for applying to a chronic medicine benefit program, to be completed by patients seeking ongoing medication coverage.
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Nouveau Medispa Medical History Form
PDF template
Comprehensive medical history form for patients seeking medical spa treatments, collecting personal and health information.
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New Patient Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal medical and surgical history, covering a wide range of health conditions and past surgical procedures.
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Meltdown Release Of Liability, Waiver Of Claims, Express Assumption Of Risk And Indemnity Agreement
PDF template
Legal document releasing liability for participation in the Meltdown Mechanical Ride, outlining potential risks and participant responsibilities.
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Member Claim Form
PDF template
A form for Quartz health plan members to submit claims for medical services paid out-of-pocket when providers will not submit claims directly.
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Member Claim Form
PDF template
Insurance claim form for submitting medical service reimbursement requests to BlueCross North Carolina.
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Member Claim Reimbursement Form
PDF template
A form for Scripps Health Plan members to request direct reimbursement for covered medical benefits and provide claim details.
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Member Claim Submission Form
PDF template
A comprehensive form for submitting medical, vision, and other healthcare-related insurance claims with detailed service type options.
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4 H Youth Development 2018 2019 Member Health Information Form
PDF template
A comprehensive health form for 4-H youth members to document medical history, conditions, medications, allergies, and emergency information.
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4 H Youth Development 2019 2020 MEMBER HEALTH INFORMATION FORM
PDF template
A comprehensive health form for 4-H youth members to record medical history, medications, allergies, and emergency information.
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Member Inquiry Form
PDF template
A comprehensive form for members to submit inquiries about medical claims, health plans, and personal information updates.
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Member PCP Transfer Request Form
PDF template
A form for healthcare providers to request transfer of a patient's primary care provider due to various clinical or administrative reasons.
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Member Reimbursement Form
PDF template
A form for members to request reimbursement for various medical services and expenses from Network Health insurance plan.
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Member Reimbursement Form
PDF template
A form for Kaiser Permanente members to request reimbursement for medical expenses paid directly to a healthcare provider.
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Membership Record Form
PDF template
A form for collecting member information and providing a legal waiver for fitness center participation.
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FORM C APPLICATION FOR MEMBERSHIP And FELLOWSHIP EXAMINATIONS
PDF template
Application form for candidates seeking membership and fellowship examinations with the West African College of Physicians.
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COA Membership ApplicationRenewal Form
PDF template
Application and waiver form for membership in the Council on Aging, serving St. Clair County seniors.
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Los Altos Senior Program Membership Form
PDF template
Membership registration form for seniors participating in Los Altos Recreation Department programs with contact and emergency information.
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INDIAN MEDICAL ASSOCIATION MEMBERSHIP APPLICATION FORM
PDF template
Membership application form for medical professionals seeking to join the Indian Medical Association as life or direct members.
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Member Travel Policy And Procedures
PDF template
Policy document outlining travel expense guidelines and reimbursement procedures for National Association of REALTORS members.
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MESA Exam7 ShippingForm
PDF template
A shipping form for documenting details of a medical exam shipment with recipient contact information and tracking details.
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Cancer, Specified Disease And Intensive Care Coverage
PDF template
Instructions for filing claims related to cancer, specified disease, and intensive care coverage under a MetLife insurance policy.
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OSSAA Physical Examination And Parental Consent Form
PDF template
A comprehensive medical screening form for student athletes to assess their health and fitness for participating in sports.
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Hardship Waiver
PDF template
Official document outlining eligibility requirements for student athletes participating in OSSAA sanctioned athletic events.
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Pre Participation Physical Evaluation Form And Parental Consent
PDF template
Official form for student-athletes to obtain medical clearance and parental consent for school sports and marching band participation in Oklahoma.
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Medical History Form
PDF template
Comprehensive form for collecting patient medical background and consent for massage therapy services.
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Research Patient Registration Form
PDF template
A comprehensive form for registering patients participating in medical research studies at Memorial Hermann - TMC.
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Treatment Perceptions Survey (TPS)
PDF template
Guidance for counties participating in the Drug Medi-Cal Organized Delivery System (DMC-ODS) waiver to conduct an annual client satisfaction survey.
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Medical History Form
PDF template
Detailed medical form focusing on patient's sleep habits, including snoring, breathing during sleep, daytime sleepiness, and overall sleep quality.
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HEALTH SUPPLY REQUISITION FORM
PDF template
A form for requesting health-related laboratory supplies and test forms from the Florida Department of Health's Bureau of Public Health Laboratories.
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2013 MICP Evaluation Form
PDF template
Evaluation form for assessing case management skills, comportment, and program performance of MICP (Medical Insurance Compensation Program) panels and staff.
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PCA 1 24 01338 Clinical FM 05142024
PDF template
A medical referral form used by primary care physicians to authorize specialist consultations and treatments within a health plan network.
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JCPS Middle School Athletic Participation Folder
PDF template
A comprehensive form for student-athletes to participate in middle school sports, including parental consent and eligibility requirements.
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Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
Official form for student athletic participation in Prince William County Public Middle Schools, covering eligibility, consent, and physical examination requirements.
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SAMPLE MIDLINE INSERTION CONSENT FORM
PDF template
A medical consent form for patients agreeing to have a midline catheter inserted, detailing potential risks and medical procedure details.
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Mileage Reimbursement Form
PDF template
Form for cancer patients to request reimbursement for medical travel expenses and miles traveled for treatment.
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Military Surplus And Other Regulated Police Equipment Waiver Request
PDF template
A form for law enforcement agencies to request waivers for specific regulated military surplus equipment from the Virginia Department of Criminal Justice Services.
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Millennium Scholarship Funds Waiver Form
PDF template
A form allowing students to waive their Millennium Scholarship funds for a specific semester and year.
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Minor Care Consent Via Phone
PDF template
A consent form for authorizing medical treatment of a minor patient through phone communication, capturing key patient and guardian information.
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Minor Consent To Travel Form
PDF template
Form authorizing transportation for minors aged 12-15 through Veyo's Non-Emergency Medical Transportation program in Connecticut.
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Field Trip Permission And Medical Release Form
PDF template
Permission form for students under 18 to participate in college field trips, including medical release authorization.
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Minors In Labs Consent And Release Form
PDF template
A consent and release form for minors participating in laboratory activities at the University of Rhode Island, outlining safety procedures and parental permissions.
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Minor Consent Medical Form
PDF template
Medical consent form for students, allowing medical treatment and over-the-counter medication authorization by Caada College Health Center
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Star Island Minor Medical Release Form
PDF template
A medical release and information form for minors attending a Star Island activity or conference, detailing medical history, medications, and emergency contacts.
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Assumption Of Risk, Release From Liability, And Indemnification Form
PDF template
A consent form for parents/guardians allowing minors to participate in research or clinical activities at Yale University with potential exposure to hazardous materials.
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Minor Volunteer Parental Consent Form
PDF template
Legal form allowing parents/guardians to consent to a minor's volunteer participation at McKinley Presidential Library & Museum with liability release and media permissions.
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Minor Waiver Form
PDF template
A waiver form allowing a minor to use university recreation facilities under parental supervision and consent.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for new patients to document pain history, symptoms, and current health conditions.
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Minor Participant Forms
PDF template
Comprehensive registration and medical form for minors participating in Global Passion Ministries travel programs.
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Media Release Form
PDF template
Legal document granting Massachusetts Institute of Technology rights to record, use, and distribute an individual's image, voice, and biographical information.
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MKSAP Money Back Guarantee Refund Request Form
PDF template
A refund request form for medical professionals who did not pass the ABIM exam after completing MKSAP self-assessment questions.
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Digital Patient Intake Form
PDF template
Form for medical providers to submit patient information, treatment details, and request insurance verification for wound care products.
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Digital Patient Intake Form
PDF template
A medical form for provider and patient information collection, insurance verification, and wound treatment documentation.
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Patient Intake Form
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A medical reimbursement form for verifying insurance coverage and documentation for skin substitute treatments.
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MLD PhD Writing Skills Waiver Form
PDF template
Form for Machine Learning PhD students to waive writing skills requirement by demonstrating a first-author paper acceptance.
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MLD PhD Writing Skills Waiver Form
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Form for ML PhD students to request waiver of writing skills requirement based on published research paper.
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Patient Medical History Form
PDF template
Comprehensive medical history form collecting patient personal information, medical conditions, medications, allergies, and healthcare provider details.
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OBGYN Medical History Form
PDF template
Comprehensive medical history form for obstetrics and gynecology patients with sections covering medications, allergies, medical history, family history, and social history.
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Maisemore Local History Society Privacy Notice
PDF template
Privacy notice and consent form for Maisemore Local History Society detailing how personal data will be collected, used, and protected.
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Mount Sinai Adolescent School Based Health Center Parental Consent Form
PDF template
Parental consent form for students to receive medical services at a school-based health center, allowing medical treatment without changing existing insurance or doctor relationships.
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Bronx RHIO Consent Form
PDF template
A form allowing patients to grant or deny Montefiore Health System access to electronic medical records through Bronx RHIO network.
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No Fault Insurance Form
PDF template
A medical insurance claim form for documenting patient information and authorizing insurance benefits for accident-related medical services.
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MMCGME Required Resident Documentation
PDF template
Comprehensive documentation requirements for new, continuing, and graduating medical residents and fellows.
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PreventiveCareAppealForm 20200507 V1.0
PDF template
Form for submitting preventive care exam documentation to Medical Mutual Wellness for wellness program compliance.
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Patient And Insurance Claim Form
PDF template
A standardized form for submitting medical insurance claims with patient and subscriber information details.
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BluePearlVet.Com Patient Assessment Form
PDF template
A form for referring veterinarians to provide detailed patient information to BluePearl veterinary clinicians for advanced medical care consultation.
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Jobbers Fireworks Retail Waiver Form
PDF template
A waiver form for Missouri residents purchasing fireworks from permitted jobbers outside of standard fireworks seasons, certifying use outside of Missouri.
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Mobile Mammography Unit Registration Form
PDF template
A comprehensive registration form for patients seeking a mobile mammography screening, collecting medical history, personal, and insurance information.
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VSU Participation Agreement And Waiver Form For Minors
PDF template
Comprehensive legal release form for minors participating in university-sponsored programs, acknowledging risks and liability waivers.
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Model Authorization Form For Certified Application Counselors (CACs) In A Federally Facilitated Mark
PDF template
A consent form allowing Certified Application Counselors to handle and process personally identifiable information for healthcare marketplace enrollment assistance.
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United Way For Greater Austin Model Community Client Privacy Policy
PDF template
A privacy policy describing information collection and sharing practices for social service platform operated by United Way for Greater Austin
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Model Consent Form For Adults
PDF template
A template consent form for research studies involving human participants, providing guidelines for obtaining informed consent from adult participants.
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Michigan State University Media Release Form
PDF template
Legal document authorizing Michigan State University to use participant images and recordings for promotional and educational purposes.
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Media Release Form
PDF template
A legal release form granting Minot State University rights to use photographs or videos of the participant for various purposes.
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Media Release Form
PDF template
A legal document granting the University of Memphis permission to use an individual's name, likeness, and performance for educational and promotional purposes.
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Patient Intake Form
PDF template
Comprehensive medical intake form for new chiropractic patients to collect personal, medical, and health history information.
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Modulo Di Rilascio Visitor Pass Visitor Pass Form
PDF template
A form for registering visitors to Bocconi University, collecting personal and contact information with data privacy consent.
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COVID 19 Vaccine Consent And Notice Form
PDF template
A comprehensive form for patients to provide consent and personal information for receiving a COVID-19 vaccine, including details about personal health information collection and use.
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MOHS Referral Form
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Medical referral form for physicians to submit patient details for Mohs micrographic surgery for skin cancer treatment.
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Money Insurance Proposal Form
PDF template
Insurance proposal form for money protection and insurance coverage by Fidelity Shield Insurance Company in Kenya.
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Insurance Of Money Proposal
PDF template
Insurance coverage proposal for loss of money in various scenarios including transit, premises, and personal custody.
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Monroe Community College International Student Accident And Sickness Insurance Waiver Form
PDF template
A waiver form for international students to demonstrate alternative health insurance coverage in lieu of the college's mandatory insurance plan.
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Multi Media Release Form
PDF template
A form authorizing Montclair State University to use photographs, video, and audio recordings for instructional and promotional purposes.
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EWOG MDSSAA Invoice Form For Morphology
PDF template
A medical form for collecting patient morphology data, laboratory samples, and clinical information related to hematological conditions.
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Medical Information Release Form
PDF template
A form authorizing Mosaic Comprehensive Care to send or receive medical records and patient health information to/from specified providers.
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PATIENT INFORMATION AND MEDICAL RELEASE FORM (FORM I)
PDF template
A comprehensive form for patient medical information, insurance details, and authorization for medical information release and claims processing.
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Parental Consent Form
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A consent form allowing treatment of a minor child at Medical Park Family Care, with options for treatment authorization and contact details.
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DOCUMENTARY CONSENT FORM
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A consent form for participants in a documentary film produced by College of DuPage's Motion Picture/Television program.
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MR089S Annual Medical Examinations
PDF template
Detailed medical examination requirements and procedures for U.S. Astronauts including annual health evaluations and audiometry testing.
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Confidentiality Agreement
PDF template
A confidentiality agreement for Medical Reserve Corps volunteers outlining patient privacy and HIPAA compliance responsibilities.
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Patient Booking Form A
PDF template
A comprehensive form for patient admission and medical booking details with sections for personal, insurance, and medical information.
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CEAR Construction And Erection All Risk Policy
PDF template
A comprehensive insurance policy covering project works, third-party liability, and potential delays in project start-up for construction and erection projects.
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Sleep Respiratory Requisition
PDF template
Medical referral form for sleep apnea testing, pulmonary function tests, and oxygen therapy assessment
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Sleep Respiratory Requisition
PDF template
Medical referral form for sleep apnea testing, pulmonary function tests, and oxygen therapy assessment
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MRI SERVICE ORDER FORM
PDF template
Comprehensive form for ordering various MRI diagnostic imaging services with multiple body region and contrast options.
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Athletic ParticipationPhysical Examination Form
PDF template
Consent form for middle school students (grades 5-8) to participate in interscholastic athletic activities, including medical and emergency contact information.
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PLAN YEAR 2024 ENROLLMENTCHANGE FORM MEDICAL SPENDING CONVERSION (MSC) HEALTH BENEFITS BUY OUT WAIVE
PDF template
Form for NYC employees to enroll in or change health benefits buy-out waiver program for plan year 2024.
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MSCR Media Release Form
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A legal form granting permission for the University of New Mexico to record and use an instructor or presenter's image, voice, and performance for educational or promotional purposes.
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American College Of Theriogenologists Self Assessment Form
PDF template
A comprehensive self-assessment form for veterinary professionals to document their clinical experience across different animal species and reproductive techniques.
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Motorcycle Safety Course Waiver Indemnification
PDF template
Legal waiver and release form for participants in a motorcycle safety training course, acknowledging risks and physical requirements.
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Motorcycle Safety Course Waiver Indemnification Form
PDF template
Legal waiver and participant information form for motorcycle safety course in Michigan, requiring consent and acknowledging risks.
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MSHSAA Preparticipation Physical FormsProcedure Medical History Form
PDF template
A comprehensive medical history form for student athletes to be completed by students or parents and reviewed by healthcare professionals.
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Texas Tech University HSC School Of Medicine Year 4 Rotations Student Evaluation Form
PDF template
Comprehensive evaluation form for assessing fourth-year medical students' clinical performance across multiple competency areas.
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FCPS Middle School Sports Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
A comprehensive form for middle school students to participate in interscholastic athletic programs, requiring student and parental consent and a physical examination.
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Michigan State University Media Release Form
PDF template
A legal document authorizing Michigan State University to use participant images and voice recordings for promotional and educational purposes.
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Missouri Fine Arts Academy Medical ReleaseEmergency Form
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A medical form for collecting student health information, emergency contacts, and parental consent for medical treatment.
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Missouri State University Sugar Bears Dance Team Medical And Liability Release
PDF template
A liability release and medical consent form for participants in the Missouri State University Sugar Bears Dance Team program
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Missouri State University Sugar Bears Dance Team 2023 24 Medical And Liability Release
PDF template
A medical and liability release form for participants of the Missouri State University Sugar Bears Dance Team for the 2023-24 season.
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Data Protection Consent Form
PDF template
A consent form detailing how MUA Ltd collects, processes, and protects personal data in compliance with the Data Protection Act 2017.
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Withdrawal Of Consent Form
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A form allowing individuals to withdraw consent for personal data processing under the Data Protection Act 2017 in Mauritius.
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Employee Disability Claim Form
PDF template
Comprehensive guidelines for completing an employee disability claim form with detailed instructions for each section.
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MUI UI Incident Report Form
PDF template
A comprehensive form for documenting and reporting incidents involving participants, including details of occurrence, medical treatment, and follow-up actions.
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Prenatal Risk Assessment Form
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Comprehensive medical form for documenting patient pregnancy information, medical history, and potential risk factors during prenatal care.
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Volunteer Application Form
PDF template
Comprehensive application form for individuals interested in volunteering at MVH/IFCH hospital, covering personal details, preferences, and background information.
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Medical Claim Reimbursement Request
PDF template
A form for members to request reimbursement for medical expenses paid out of pocket, requiring itemized receipts and proof of payment.
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Consent And Authorization To Procure Motor Vehicle Record (MVR)
PDF template
A consent form allowing Northeast Wisconsin Technical College to obtain and review an individual's motor vehicle record for employment or driving purposes.
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My Medical Alert Passport
PDF template
A comprehensive medical form designed to help individuals, particularly those with autism, communicate their medical needs and personal preferences to healthcare providers.
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MWSU Mystics Dance Team Medical Release
PDF template
Medical release and liability waiver for participants in MWSU Mystics Dance Team clinics and tryouts.
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Enrollment Form
PDF template
A comprehensive enrollment form for patients seeking to enroll in VYVGART treatment pathway and services.
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Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical evaluation form for athletes to assess physical fitness and health status prior to participation in sports activities.
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Health Examination Form
PDF template
A comprehensive medical evaluation form for documenting a child's health status and medical history for school or sports participation.
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NADR Change Order Request
PDF template
Form for requesting changes to animal information in the North American Deer Registry database.
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Health Examination Form For Admission To Nurse Aide Training Program
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A medical health screening form required for admission to a nurse aide training program, including tuberculosis testing and vaccination documentation.
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Nominations Agreement Form
PDF template
A form for professionals to be considered for board positions within the NAIOP Southern Nevada organization, detailing professional experience and leadership interest.
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Waiver And Release Of Liability
PDF template
Legal document waiving liability for potential COVID-19 exposure at Naish Scout Reservation during Boy Scouts activities.
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Parental Consent Form For Participation In Research Study
PDF template
A parental consent form for a youth narrative research study exploring Wyoming's future through a creative contest and academic research project.
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NAR Settlement FAQs
PDF template
Detailed FAQ document explaining the key terms and implications of a settlement related to real estate broker commissions and liability.
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NASA Media Release For Adults
PDF template
A legal document allowing NASA to interview, photograph, or record an individual for media and promotional purposes.
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NASA Media Release For Adults
PDF template
A legal document allowing NASA to interview, photograph, and use an individual's likeness for various media productions without compensation.
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NASA Media Release Form For Adults
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Legal form granting NASA permission to use an individual's images, voice, and likeness for promotional and instructional materials.
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NASA Media Release Form For Parent Or Guardian Of Minor
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A consent form allowing NASA to photograph, interview, and record a minor for educational and promotional purposes.
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Media Release Form
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A legal document granting permission for recording, photographing, and using an individual's likeness for media purposes by C.A.S.E. and the National Center.
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Post Employment Health Plan (PEHP) Claim Form
PDF template
Form for requesting medical expense reimbursement for post-employment health benefits, including insurance premiums and medical expenses.
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Native Kidney Biopsy Requisition Form
PDF template
Medical form for requesting and documenting details of a native kidney biopsy procedure, including patient medical history and clinical information.
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NatureS Healers Patient Intake Form
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Comprehensive medical intake form for patients considering hyperbaric oxygen therapy, including medical history and potential contraindications.
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NCAA Division I Drug Testing Consent Form 22 1b
PDF template
A mandatory consent form for NCAA Division I student-athletes authorizing year-round drug testing and acknowledging testing consequences.
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Authorization To Release AndOr Disclose Protected Health Information
PDF template
A form authorizing the release of protected health information between NCCU Student Health and Counseling Services and specified parties.
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North Carolina FFA Center Consent Form
PDF template
A consent and liability release form for students attending the North Carolina FFA Center camp, outlining participant policies and photo permissions.
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North Country HealthCare ParentalPatient Consent Form
PDF template
Consent form for healthcare services provided by North Country HealthCare's School-Based Health Services Mobile Unit for students and parents/guardians.
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Media Release Form
PDF template
A legal document allowing The National Center for Outdoor & Adventure Education to use participant images for promotional and marketing purposes.
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Health Examination Certificate North Carolina Public Schools
PDF template
Required medical certification form for school employees verifying health status and ability to perform job duties
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Residency Program In Clinical Parasitology
PDF template
Competitive funding program for veterinarians pursuing a PhD in Veterinary Parasitology with clinical training and board certification potential.
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CSS Profile Waiver Request For The Noncustodial Parent
PDF template
A form for students to request a waiver from providing noncustodial parent financial information on the CSS Profile application.
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NINDS Repository Tissue Biopsy Shipping Instructions
PDF template
Detailed instructions for collecting, labeling, and shipping tissue biopsy samples for the NINDS Repository.
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HazardIncident Report Form
PDF template
A form used to report and document health and safety hazards or incidents within an organization, tracking details, recommended actions, and resolution.
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ADA Request Medical Form
PDF template
A medical form used to assess an employee's disability status and potential workplace accommodations under the ADA.
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Initial Contract Routing Notification Of Risk
PDF template
A document outlining the risks and confidentiality requirements associated with contract routing and document handling.
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New England Food Allergy Treatment Center Medical History Form
PDF template
Comprehensive medical history form for documenting patient's food allergies, medical history, and current health status.
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DSS NEMT 970 SOUTH DAKOTA MEDICAID NON EMERGENCY MEDICAL TRAVEL (NEMT) REIMBURSEMENT FORM
PDF template
A form for Medicaid recipients to document and request reimbursement for non-emergency medical transportation services in South Dakota.
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Bridge Replacement Scoping Trip Risk Assessment Form
PDF template
A comprehensive form for documenting bridge replacement project details, FEMA flood zone considerations, and field review findings.
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Netball Waiver
PDF template
Legal document releasing liability for risks associated with netball participation, including COVID-19 related risks.
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Neuro Ophthalmology Referral Form
PDF template
A medical referral form for patients seeking ophthalmology services at Emory Eye Center, requiring patient and referral details.
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Neuroscience Conference Service Agreement Form
PDF template
Agreement for professional conference services provided by Hawaii Pacific Neuroscience, covering event coordination, catering, and service terms.
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ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
PDF template
A legal document that waives liability for participation in activities and acknowledges potential risks of engagement.
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Preparticipation Physical Evaluation
PDF template
Comprehensive medical evaluation form for assessing an individual's physical fitness and health status prior to participation in an activity.
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Order Form For Newborn Screening Kits
PDF template
A form for ordering specimen collection cards and pre-addressed envelopes for newborn screening from the Office of Laboratory Services.
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980 Retiree Welcome Packet Retirement Medical Benefit Account Claim Form
PDF template
A claim form for retirees to submit medical insurance premium reimbursement requests with specific documentation guidelines.
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New Client Registration Agreement
PDF template
A registration agreement outlining client responsibilities and expectations when receiving veterinary services for their pets.
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Waiver Of Liability, Promise Not To Sue, Assumption Of Risk And Agreement To Pay Claims
PDF template
A comprehensive legal document waiving liability and assuming risks for participation in a university-sponsored activity.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient medical history, symptoms, and personal health information.
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PATIENT GASTROENTEROLOGY HISTORY FORM
PDF template
Comprehensive medical intake form for gastroenterology patients, collecting personal, demographic, and insurance information.
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New Hire Assessment Form Attachment B
PDF template
A form for new hires to disclose medical conditions, restrictions, and potential job-related health exposures prior to starting employment.
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Histology Service Request Form
PDF template
A comprehensive form for requesting histology laboratory services, including biospecimen processing, staining, and immunohistochemistry analysis.
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Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, medical, and insurance information for healthcare providers.
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Annual Minor Participant Health And Medical Form
PDF template
Comprehensive medical information form for minors under 18 years old, collecting health details, emergency contacts, and medical consent.
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New Participant Medical Form
PDF template
A comprehensive medical information form for new participants requiring detailed health history and medical details
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New Patient Intake Form
PDF template
Comprehensive form for collecting new patient medical information, health history, and insurance details.
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Patient Information Packet
PDF template
Welcome packet for new pediatric speech and occupational therapy patients, including required documentation for therapy services.
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NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive medical form for collecting new patient personal, contact, insurance, and emergency contact information.
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Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient personal information, insurance details, medical history, and treatment authorization.
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Otolaryngology Head And Neck Surgery Consultation
PDF template
Comprehensive medical consultation form for otolaryngology patients, covering detailed review of systems and medical history.
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New Patient Information Form
PDF template
A comprehensive form for collecting client and pet details for veterinary physiotherapy services.
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New Patient Insurance Form
PDF template
A comprehensive intake form for new patients seeking outpatient therapy, collecting personal, insurance, and referral information.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting new patient personal, contact, medical, and insurance information.
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Patient Information Sheet
PDF template
A patient information and policy document for a gynecological medical practice outlining registration requirements, payment policies, and office rules.
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TRI COUNTY FAMILY MEDICINE NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting patient medical history, current medications, allergies, and recent medical history
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New Patient Intake Form
PDF template
A comprehensive medical form for collecting new patient personal, contact, medical history, and emergency contact information.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new pediatric patients, collecting personal, medical, and insurance information.
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New Patient Intake Form
PDF template
Comprehensive form for collecting new patient medical history, personal information, and health status for medical practice intake.
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Dermatology Patient Intake Form
PDF template
Comprehensive patient intake form for dermatology practice including personal information, insurance details, and medical consent.
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New Patient Information Form
PDF template
Comprehensive medical intake form for new patients seeking mental health services at Triad Psychiatric Practice.
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New Patient Intake Form
PDF template
Comprehensive medical form for collecting patient personal information, medical history, current health conditions, and insurance details.
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New Patient Intake Form
PDF template
Comprehensive form for new pharmacy patients to provide personal, medical, and insurance information for prescription services.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for collecting patient personal, insurance, and health information for a medical clinic or practice.
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New Patient Intake Form
PDF template
A comprehensive patient intake form for new pharmacy customers, including personal information, contact details, and insurance information.
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NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive form for collecting patient demographic, contact, and personal information for new healthcare patients.
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Blase Chiropractic New Patient Intake Form
PDF template
Comprehensive intake form for new patients seeking chiropractic services, collecting personal, contact, and employment information.
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NEW PATIENT VISIT INTAKE FORM
PDF template
Comprehensive medical intake form for pediatric patients with potential endocrine and metabolic conditions.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients to provide detailed health background and current medical conditions.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient personal, medical, insurance, and contact information for healthcare providers.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients to document medical history, current medications, and pain assessment details.
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Patient Intake Form
PDF template
Comprehensive medical intake form for naturopathic patients collecting personal, medical, and health history information.
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Allina Health John Nasseff Neuroscience Specialty Clinic New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at a neuroscience specialty clinic, collecting personal, medical, and diagnostic history.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for documenting patient medical history, pain assessment, and physical limitations.
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New Patient Intake Form
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Medical intake form for collecting comprehensive patient information for an eye care practice.
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NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history intake form for new patients, collecting personal information, medical conditions, allergies, and current medications.
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NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for new patients seeking weight management treatment, detailing weight history, triggers, and previous weight loss attempts.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive intake form for new patients at Chicago Gastro, collecting personal and medical contact information along with financial policy acknowledgment.
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PATIENT INTAKE FORM
PDF template
Confidential form for collecting comprehensive patient personal and demographic information for medical record purposes.
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New Patient Questionnaire
PDF template
Comprehensive medical history intake form for new patients covering various health conditions and medical background.
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NEW PATIENT REFERRAL FORM
PDF template
Comprehensive medical referral form for new patients seeking cardiothoracic surgical consultation, collecting patient, insurance, and medical information.
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Patient Intake Form
PDF template
A comprehensive patient intake form for collecting personal, medical, and insurance information with communication preferences and service consent.
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White Bird Medical Clinic NEW PATIENT INTAKE FORM
PDF template
Comprehensive intake form for new patients at White Bird Medical Clinic, collecting personal, demographic, and medical background information.
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NEW PATIENT INTAKE FORM (With TriCare Insurance)
PDF template
Comprehensive medical intake form for new patients, collecting detailed personal and medical history information.
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NEW Patient Pediatric Orthopaedic And Sports Medicine Medical History Form
PDF template
Comprehensive medical history form for pediatric patients in orthopaedic and sports medicine practice, capturing patient details, medical history, and family health information.
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Medical Examination Form Examining Physician Must Fill Out
PDF template
A comprehensive medical assessment form for evaluating an individual's fitness for missionary service, requiring detailed physical examination and medical history.
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NEW ELBOW PATIENT INTAKE FORM
PDF template
Medical intake form for patients experiencing elbow-related symptoms, designed to gather comprehensive information about the patient's condition and medical history.
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NEW HIP PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients experiencing hip-related symptoms or concerns.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients at Rowan Tree Medical, collecting personal, medical, and contact information.
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HIPAA AUTHORIZATION FOR MEDICAL RECORDS
PDF template
A form authorizing the release of patient medical records with specific conditions and consent parameters.
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Demographic Form
PDF template
Comprehensive patient intake form collecting personal, contact, insurance, and medical information for Centeno-Schultz Clinic.
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Volunteer Participation Agreement And Acknowledgement Of Risks
PDF template
A legal document for volunteers to acknowledge risks and waive liability when participating in research activities at the university.
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Patient Information Form
PDF template
A comprehensive medical intake form collecting patient personal, insurance, and workplace injury details for healthcare providers.
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NOAA Form 57 10 05 Medical Form For Minors
PDF template
A comprehensive medical information and consent form for minors participating in NOAA ship voyages, capturing health details, emergency contacts, and parental permissions.
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NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A standardized medical form developed by NFHS Sports Medicine Advisory Committee to manage skin lesions and communicable skin disorders in wrestling.
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Consent Agreement Form (Kyodaku Sho)
PDF template
A consent form for Waseda University doctoral students to authorize electronic publication and public access to their dissertation.
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Health Care Coverage Waiver Form
PDF template
A form for employees to waive health insurance coverage offered by their employer and provide alternative coverage details.
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NIC Web Privacy Policy
PDF template
A comprehensive privacy policy explaining how NIC collects, uses, and manages personal data from website visitors and event participants.
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Roswell Park Cancer Institute Volunteer Application Form
PDF template
Comprehensive form for potential volunteers to provide personal, contact, and background information for Roswell Park Cancer Institute.
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National Incident Investigation Form (NIIF)
PDF template
A systematic form for documenting and investigating workplace incidents, their causes, and outcomes.
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Nine Hour Summer Requirement Waiver Form
PDF template
A form for Florida A&M University students to request a waiver of summer credit hour requirements with academic dean approval.
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Arizona National Interest Waiver Program Transfer Form
PDF template
A transfer form for healthcare professionals participating in Arizona's National Interest Waiver program to change their service site location.
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Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical form for evaluating an individual's physical fitness and health status prior to participating in sports or athletic activities.
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New Jersey Medical Power Of Attorney
PDF template
A legal document allowing an individual to designate an agent to make healthcare decisions on their behalf in New Jersey.
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NJPEC 1634 19 Therapy Services Request Form
PDF template
A healthcare form for requesting and documenting therapy services, including patient and provider information, diagnosis, and treatment details.
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HEALTH, ACCIDENT, DISABILITY CLAIM FORM
PDF template
Comprehensive claim form for health, accident, and disability insurance claims from National Teachers Associates Life Insurance Company.
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Part I Medical History And Release Form
PDF template
A comprehensive medical history form for participants in the National Leadership Challenge, designed to aid medical treatment and emergency response.
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Namibian Motorsport Federation Accident Report Form
PDF template
A comprehensive form for documenting accidents and medical incidents during motorsport events in Namibia.
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Informed Consent, Release Agreement, And Authorization
PDF template
A legal document for participant consent, medical authorization, and risk acknowledgment for Scouting activities and expeditions.
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Emergency Contact Form
PDF template
A comprehensive form for collecting student emergency contact details, medical information, and parental consent for medical treatment.
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NOAA Form 57 10 20 OMAO Privacy And Consent Form
PDF template
Privacy act statement for collecting health and medical records at the National Oceanic and Atmospheric Administration (NOAA)
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Boarding Agreement Form
PDF template
A comprehensive form for pet boarding services detailing vaccination requirements, medical emergency procedures, and boarding terms.
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No Fault Insurance Form
PDF template
A form for filing a no-fault insurance claim with personal and injury details for insurance processing.
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NOMINEE CONSENT FORM FOR REGION AT LARGE ELECTIONS
PDF template
A consent form for nominees in a regional election process, requiring candidate confirmation and contact details.
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Data Protection Consent Form
PDF template
A form allowing an account holder to authorize a nominated person to discuss their water service account details.
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Non ACGME Fellowship Application
PDF template
A comprehensive application form for medical professionals seeking specialized fellowship training in various oncology and medical subspecialties.
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Toquaht Nation Government Non Insured Health Benefit Application Form
PDF template
Application form for Toquaht Nation citizens to request health benefits funding for various medical services and expenses.
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Non Medication Preauthorization Request
PDF template
A form for healthcare providers to request preauthorization for non-medication medical services and procedures from the Motion Picture Industry Health Plan (MPI).
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Private Medical Consultations Price List
PDF template
Comprehensive pricing guide for private medical services, consultations, certificates, and travel-related medical procedures
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APPLICATION FOR OUT OF STATE TUITION DIFFERENTIAL WAIVER NON RESIDENT STUDENT
PDF template
Application form for non-resident students seeking waiver of out-of-state tuition differential at Valdosta State University based on family domicile in Georgia.
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Non Resident Tuition Waiver Application
PDF template
Application for out-of-state students to waive non-resident tuition fees at Florida International University based on specific eligibility criteria.
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Non University Passenger Waiver Form
PDF template
Form authorizing transportation of non-university passengers in university vehicles under specific policy conditions.
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CSRD FAQs On Enrollment Of Non Veterans
PDF template
Detailed guidelines for enrolling non-Veterans in Clinical Science Research and Development (CSRD) funded studies at the Department of Veterans Affairs.
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REGISTRATION FORM
PDF template
Registration form for filing health care directives with the North Carolina Secretary of State, including various medical and end-of-life documents.
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Northeast Community Center Liability Waiver
PDF template
A legal document waiving liability for participants and their children using Northeast Community Center facilities and activities.
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North Grove Equestrian Park Equine Release And Waiver Of Liability, Assumption Of Risk, And Indemnit
PDF template
A legal document releasing North Grove Equestrian Park from liability for potential injuries or damages related to horseback riding and equine activities.
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2024 2025 Northside ISD Medical History
PDF template
Annual medical history form required for student athletes to participate in school sports activities
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Northside Boxing Club Membership Form Waiver
PDF template
Comprehensive membership form for boxing club participants, including personal information, medical history, and liability waiver.
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Requisition Form For Surgical Pathology, Cytopathology, And Hematopathology
PDF template
A form for requesting additional ancillary studies on archived pathology cases more than 30 days after initial sign-out.
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Notice Of Emergency Procurement
PDF template
A document detailing an emergency medical procurement for a life-flighted patient at Utah Valley Medical Center
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Excess Secondary Insurance Plan For Sports Club Athletes
PDF template
Insurance policy document outlining coverage details for San Diego State University sports club athletes, explaining secondary insurance provisions and claim procedures.
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Authorization Request Form
PDF template
Medical service authorization request form for providers to submit routine and urgent pre-service requests for patient care.
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Novi Parks, Recreation Cultural Services Waiver Form
PDF template
A comprehensive liability waiver for participation in City of Novi recreational activities and events, covering in-person and online programs.
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Consultation Referral Form
PDF template
A medical referral form for patients seeking specialized consultations in sleep, pulmonary, and allergy evaluations.
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Designation (Family And Medical Leave Act)
PDF template
Official form for employers to designate and communicate Family and Medical Leave Act (FMLA) leave status and entitlements to employees.
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National Pancreas Foundation Center Audit Form
PDF template
A comprehensive document outlining reporting capabilities, responsibilities, and qualifications for centers participating in the National Pancreas Foundation program.
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PATIENT INTAKE FORM
PDF template
Comprehensive patient demographic and health assessment form for chiropractic wellness center intake process.
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Patient Intake Form
PDF template
Comprehensive patient intake form for prosthetics services, collecting medical history, contact details, and amputation information.
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Patient Intake Form
PDF template
Comprehensive intake form for patients seeking prosthetic services, capturing medical history, contact information, and amputation details.
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Patient Intake Form
PDF template
Confidential form for collecting patient personal and contact information for healthcare purposes.
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NEIWPCC NATIONAL PARK SERVICE SUBRECIPIENT RISK ASSESSMENT FORM
PDF template
A form to assess organizational eligibility for collaborative subrecipient partnerships with NEIWPCC by evaluating potential risks and compliance.
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Narrow Ridge Earth Literacy Center Confidential Health Information And Medical Release Form
PDF template
Comprehensive medical history questionnaire for participants in Narrow Ridge Earth Literacy Center activities, including medical release authorization.
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NSE Media Release Form
PDF template
Official form authorizing the National Spanish Examinations to use media and personal images of participants or their children.
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NATIONAL SCIENCE FOUNDATION POLAR PHYSICAL EXAMINATION
PDF template
Medical examination form for individuals participating in polar research or expeditions, including comprehensive health assessment.
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Consent Form National Student Financial Aid Scheme
PDF template
Consent form for students to authorize NSFAS to collect and verify personal and financial information for student financial aid eligibility.
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Pathology Fellowship Application
PDF template
A comprehensive application form for medical professionals seeking a fellowship in pathology specialties at the University of Chicago (NorthShore)
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NSGFA MEDICAL HISTORY FORM
PDF template
A comprehensive medical history and emergency contact form for players, collecting personal and medical information for emergency purposes.
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North Texas Heart Center Medical Test Request Form
PDF template
Medical test request form for cardiology examinations at North Texas Heart Center with patient and diagnostic details.
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New Student Athlete Health History Questionnaire Form
PDF template
Confidential medical history questionnaire for student-athletes at Northwest University, focusing on cardiovascular risk factors and health screening.
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Medical Examination Form Nurse Aide
PDF template
A comprehensive medical history and examination form for students entering the Nurse Aide program at Virginia Western Community College.
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Medical Rehabilitation Nurses Section Referral Form
PDF template
A form for documenting medical rehabilitation referrals for injured employees through the North Carolina Industrial Commission.
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CLINICAL ASSESSMENT FORM FIRST YEAR
PDF template
A comprehensive healthcare assessment form for collecting patient medical information, history, and current health status for first-year health sciences students.
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Nurse Assistant Program Application Checklist
PDF template
Comprehensive checklist and requirements for students applying to the Nurse Assistant Program at Citrus College.
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NURSING INSTRUCTOR CONFIDENTIALITY AGREEMENT
PDF template
A confidentiality agreement for nursing instructors outlining the handling of sensitive information at Windsor Regional Hospital.
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Allied Health And Nursing Student Medical Form
PDF template
Medical form for Allied Health and Nursing students at Montgomery College to document health status and capabilities.
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Spinraza Pre Authorization Form
PDF template
A medical pre-authorization form for requesting Spinraza medication treatment, used for documenting patient details and motor ability assessments.
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Nutritional Referral Form
PDF template
Medical referral form for nutrition therapy services, used by physicians to refer patients for specialized nutritional counseling.
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PhotoMedia Release Form
PDF template
A legal release form granting permission to use personal photographs, video, and other media for publication purposes.
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Authorization To Use And Disclose Protected Health Information
PDF template
A form authorizing Nathaniel Witherell to disclose or obtain patient health information for various purposes.
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NWCD Requisition Form
PDF template
A medical requisition form for cardiac and vascular diagnostic procedures from North West Cardio Diagnostics.
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Member Medical Reimbursement Claim Form
PDF template
A claim form for Wellcare By Fidelis Care members to request reimbursement for out-of-pocket medical expenses.
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Continuation Of Disability Claim Form
PDF template
A form for reporting ongoing disability status, medical treatments, and work return details for an insurance claim.
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NYIT College Of Osteopathic Medicine Enrollment Form
PDF template
Insurance enrollment form for medical students at NYIT College of Osteopathic Medicine to select coverage options and list dependents.
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Disability Claim Form
PDF template
Comprehensive form for employees to report disability, medical information, and related benefit claims.
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Media Release Form
PDF template
Legal document granting NYSCA non-exclusive rights to use submitted media for noncommercial purposes.
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NYS School Health Examination Form
PDF template
Required health examination form for New York State school students documenting medical history and physical assessment.
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Required NYS School Health Examination Form
PDF template
Comprehensive health examination form for New York State school students documenting medical history, physical exam, and health status.
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UnitedHealthcare Community Plan Of New York Specialist Referral Form
PDF template
A referral form for UnitedHealthcare Community Plan of New York members to obtain specialist services with specific guidelines and requirements.
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New York State TAP WAIVER FORM
PDF template
A form allowing students to request a one-time waiver for academic progress requirements for New York State Tuition Assistance Program (TAP) awards.
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NEW YORK PHOTO ID WAIVER FOR MINORS
PDF template
A legal form for parents or guardians to certify a minor's identity when lacking state-issued photo identification during fingerprinting.
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City Of Oakley Recreation Program Registration Form
PDF template
Registration form for City of Oakley recreation programs and activities for families and minors
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Oath And Consent Form
PDF template
Application form for teacher education licensure program, requiring disclosure of criminal history and personal information.
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Patient Medical History Form
PDF template
A comprehensive form for capturing patient's current health status, medical conditions, medications, and medical history.
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OB Pre Registration Form
PDF template
A comprehensive patient information form for expectant mothers to pre-register for maternity services at Howard County Medical Center.
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English Patient Intake Form
PDF template
A comprehensive medical intake form for collecting patient personal and contact information.
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OBS 0901 COVID19RPP Test Requisition Form
PDF template
A comprehensive medical form for requesting COVID-19 and respiratory pathogen panel (RPP) testing, collecting patient and clinical information.
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Observation Experience Policy OBSERVATION AGREEMENT FORM
PDF template
Form for individuals seeking to observe healthcare professionals at a medical facility, outlining health requirements and confidentiality agreements.
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Oregon Coast Community College Media Release Form
PDF template
A legal document granting Oregon Coast Community College permission to use photographs, videos, and other media of an individual for various purposes.
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Employee Medical Condition Questionnaire
PDF template
Comprehensive medical history and health status form for employees, covering medical conditions, treatments, and workplace accommodations
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form capturing patient health history, nutrition, lifestyle, and wellness information.
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Consent Form For Disclosing Name And Other Personal Information Contained In The Discrimination Co
PDF template
A form that provides consent for the Office for Civil Rights to disclose personal information during a discrimination investigation.
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Request For Medicaid Home And Community Based Services (HCBS) Waiver
PDF template
Official form for requesting enrollment in Ohio Medicaid home and community-based services waiver program for eligible individuals.
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STANDARD AUTHORIZATION FORM
PDF template
Standard form authorizing the release of health information between covered entities with specific disclosure terms and patient consent requirements.
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ODNR Volunteer Information
PDF template
A form for volunteering with the Ohio Department of Natural Resources that includes volunteer details and a legal waiver and release of liability.
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Waiver Service Request Form
PDF template
A form and guide for documenting and processing requests for changes or new services in a waiver program.
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Trinity College Outdoor Programs Medical History Form
PDF template
A comprehensive medical history form for participants in Trinity College outdoor programs, designed to assess health risks and preparedness for wilderness activities.
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Early Field Experience Internship I Permission Form
PDF template
A consent form for parents/guardians to allow a teacher education student to record and use their child's classroom interactions and work for educational assessment purposes.
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Miami Dade College Off Campus Activity Student Agreement Form
PDF template
A legal agreement for students participating in off-campus activities, acknowledging risks and releasing the college from liability.
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Off Campus Event Risk Assessment Form
PDF template
A comprehensive form for evaluating risks and safety protocols for off-campus university events and activities.
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IWU University Sponsored Off Campus Travel Form
PDF template
A liability release and consent form for students participating in off-campus university-sponsored travel activities.
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Office Environment Assessment
PDF template
A comprehensive assessment tool for evaluating healthcare facility physical accessibility, appearance, space adequacy, and record-keeping practices.
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Congressional Youth Advisory Council Legal Guardian Authorization And Media Release Form
PDF template
Legal consent and media release document for youth participation in Congressional Youth Advisory Council program administered by Congresswoman Veronica Escobar.
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Consent Form
PDF template
A form allowing students to authorize specific individuals to receive and discuss their student conduct records at Savannah State University.
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IBEW Local No. 683 Health Welfare Fund Weekly Disability Benefits Claim Form
PDF template
Claim form for obtaining weekly disability benefits from the IBEW Local No. 683 Health & Welfare Fund, providing compensation for disabled workers.
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Official Health Records Request
PDF template
A form for students to request release of immunization and health records from Herkimer College.
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Official Indiana Animal Bites Report
PDF template
Official state form documenting details of an animal bite incident, including victim and animal information for potential rabies exposure.
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CITY OF OCONTO FALLS VOLUNTEER FORM
PDF template
A form for registering volunteers and obtaining legal release for participation in City of Oconto Falls activities.
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WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION CONSENT FORM
PDF template
Legal document releasing liability for participants in a cultural diversity colloquium sponsored by Texas A&M Rangel College of Pharmacy.
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REQUEST FOR MEDICAID HOME AND COMMUNITY BASED SERVICES (HCBS) WAIVER
PDF template
A form for requesting enrollment in Medicaid home and community-based services waiver in Ohio for individuals needing long-term care support.
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Hazard Inspection Hazard Identified Report Form
PDF template
A comprehensive form for reporting and assessing workplace safety hazards and recommended corrective actions.
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Old Mill Park Docking Kayak Rental Agreement Form
PDF template
Rental agreement for kayak equipment from Old Mill Park, outlining rental terms, safety requirements, and liability waivers.
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MINOR PARTICIPANT AGREEMENT FORM
PDF template
Legal consent form for parents/guardians to allow minor children to participate in camp and retreat center activities, including risk acknowledgment and publicity waiver.
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Olustee Fun Run Waiver Form
PDF template
Waiver form for participants in a community running event, outlining event rules and liability release.
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Followup Patient Intake Form
PDF template
A comprehensive medical form for tracking patient status, medications, pain levels, and post-operative health details.
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OMHSAS Request For Waiver Form
PDF template
A form for facilities or agencies to request a waiver from the Office of Mental Health and Substance Abuse Services in Pennsylvania.
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TRAVEL FORM Observership Program
PDF template
A travel form for participants in the Open Medical Institute's Observership Program, detailing travel arrangements to Austria.
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TRAVEL FORM Observership Program
PDF template
Travel documentation form for participants in the Observership Program, requiring travel details and ticket information.
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One Medical Passport Downtime Instructions
PDF template
Instructions for hospital staff to follow during extended One Medical Passport system downtime, providing alternative procedures for booking requests and document submission.
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OMSI Outdoors Health And Medical Form
PDF template
A comprehensive health and medical form for students and adults participating in OMSI Outdoors programs, collecting personal, medical, and emergency contact information.
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Onboarding Checklist
PDF template
Comprehensive checklist for students to complete administrative documents and preparation tasks for program participation.
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ONE Program Patient Intake Form
PDF template
A comprehensive medical intake form for assessing patient risk factors related to opioid medication use and potential interactions.
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Youth Protection Program Online Participation Agreement And Waiver Form
PDF template
A consent form for youth program participation that includes online activity waivers and risk acknowledgments for University of Central Florida programs.
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Online Privacy Policy Agreement
PDF template
A comprehensive privacy policy detailing how Freedom Hills Therapeutic Riding collects, uses, and protects user personal information.
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Online Privacy Policy Agreement
PDF template
A comprehensive privacy policy outlining how Park Cities School Of Music collects, uses, and protects user personal information through their website and online services.
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Membership Dues Waiver Request
PDF template
A form for SPJ members experiencing financial hardship to request a temporary six-month dues waiver and continue membership.
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MIT Overnight Program Medical Release Form
PDF template
A medical release form required for minors participating in the MIT Overnight Program, collecting medical and emergency contact information.
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Ontario Works Medical Travel Form
PDF template
A form for social services clients to claim medical travel expenses and transportation costs for reimbursement.
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EPO REFERRAL FORM
PDF template
A referral form for healthcare providers to request out-of-network specialist services through Common Ground Healthcare (CGHC)
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Media Release Form
PDF template
Form granting permission for students to be photographed, recorded, or featured in media by Murray City School District.
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UNC Ophthalmology Referral Form
PDF template
A comprehensive referral form for patients seeking ophthalmology services at UNC Health locations.
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WFU Outdoor Pursuits Medical Form
PDF template
A comprehensive medical form for WFU Outdoor Pursuits participants collecting personal, emergency contact, and insurance information.
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Student Drug Testing Consent Form
PDF template
A consent form for parents and students participating in the school district's mandatory drug testing program for students involved in extracurricular activities.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and insurance information for medical treatment.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and insurance information with consent and assignment sections.
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Referral Form
PDF template
A medical referral form for patient consultation and transfer of medical information between healthcare providers.
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OPT OUT AFFIDAVIT
PDF template
A form for healthcare practitioners to formally opt out of Medicare billing and payment systems for a two-year period.
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Opt Out Media Release Form
PDF template
A form allowing parents to withhold permission for their child to be photographed, videotaped, or audio recorded during school activities.
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Voluntary Waiver Of Health Insurance For Enrollment In Opt Out Program
PDF template
A voluntary form allowing City of Somerville retirees to waive health insurance coverage in exchange for a monetary opt-out payment.
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High Bridge Oral History Project Consent Form
PDF template
A consent form for documenting personal histories from Borough of High Bridge residents, including recording and usage permissions.
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Division Of Oral Medicine And Dentistry New Patient Intake Form
PDF template
A comprehensive medical intake form used by oral medicine and dentistry practices to collect patient health history and contact information.
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ParentGuardian Consent Form
PDF template
Consent form for parents/guardians of participants under 18 years old to participate in the Duke of Edinburgh's International Award program.
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American College Of Surgeons Order Form
PDF template
Order form for purchasing publications and products from the American College of Surgeons with payment and shipping instructions.
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BP S606.010 INFORMED CONSENTCONSENT TO RELEASE INFORMATION FOR RESEARCH
PDF template
A detailed form outlining the requirements and guidelines for obtaining informed consent in research studies conducted within the Federal Bureau of Prisons.
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Casework Consent And Information Form
PDF template
A form allowing individuals to grant permission for Congressman Kilili Sablan's office to access and discuss their case with federal agencies.
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Medical History Form
PDF template
Comprehensive medical form for collecting patient's personal and family health information, medical conditions, medications, and social history.
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ORL Research Internship Application Instructions
PDF template
Application guidelines and form for research internship at the Leni & Peter W. May Department of Orthopaedics Research Laboratories
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NEW PATIENT QUESTIONNAIRE
PDF template
Comprehensive medical intake form for new patients seeking orthopaedic surgery consultation, collecting patient medical history, goals, and current health information.
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Orthopedics Medical History Form
PDF template
Comprehensive medical history form for documenting orthopedic patient's injury, pain, and medical condition details.
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UTHSC Orthodontic Referral Form
PDF template
A comprehensive medical referral form for orthodontic evaluation and treatment at the University of Tennessee College of Dentistry.
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OSF System Laboratory Client Clinical (Green) Requisition Form Instructions
PDF template
Comprehensive instructions for completing a clinical laboratory requisition form with detailed field guidance and billing requirements.
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OSF System Laboratory Client CytologyPathology Requisition Form Instructions
PDF template
Detailed instructions for submitting cytology and surgical pathology specimens to OSF System Laboratory with specific guidelines for form completion.
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Osher Institute Membership Enrollment Form
PDF template
Enrollment form for joining the Osher Institute, including liability waiver, media release, and payment information.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients seeking spine-related medical care, capturing patient history, pain details, and symptom assessment.
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Medical Form
PDF template
Confidential medical form for collecting student health information prior to educational travel programs, enabling emergency preparedness and medical screening.
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Patient Intake Form
PDF template
Comprehensive form for collecting patient personal, medical, and insurance information for healthcare providers.
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Pedicab Medical Form
PDF template
A medical examination form to determine physical fitness for pedicab operation, completed by a licensed physician.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient medical history, pain assessment, and personal health information.
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Health Examination Form
PDF template
A comprehensive medical history and physical examination form for students entering the Occupational Therapy Assistant program at Delgado Community College.
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REQUEST FOR WAIVER FORM
PDF template
A form for requesting a waiver of Minority and Women-Owned Business Enterprise (M/WBE) participation goals in New York State procurement contracts.
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Record Of Other Insurance Form
PDF template
A comprehensive form for collecting student and family insurance and employment details for the Foothill-DeAnza Community College District.
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Excess Accident Medical Expense Insurance Claim Requirements Guidance
PDF template
Guidelines for submitting medical insurance claims for sports-related injuries with detailed documentation requirements for students.
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OtolaryngologyENT Medical History Form
PDF template
Comprehensive medical history form for children visiting an Ear, Nose, and Throat (ENT) specialist, collecting patient details, medical history, medications, and allergies.
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Otolaryngology Head And Neck Surgery Patient Medical History Form
PDF template
Comprehensive medical history form for patients visiting an Ear, Nose, and Throat (ENT) clinic, collecting patient details, medical conditions, and past surgical history.
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Membership Application And Agreement
PDF template
Application form for membership in On Target Sports LLC with legal certification for firearm ownership eligibility.
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IRB TEMPLATE FOR DEVELOPMENT OF THE ADULT CONSENT FORM
PDF template
A template guide for creating adult consent forms for social science and behavioral research studies at Oakwood University.
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Out Of Network Referral Form
PDF template
A form for requesting authorization to see an out-of-network healthcare provider with detailed patient and service information.
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Out Of State Immunizations Record Transfer Request (680 Form) Instructions
PDF template
Instructions for transferring out-of-state immunization records for a child with the Florida Department of Health in St. Johns County.
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Medical Diagnostic Test Requisition
PDF template
A comprehensive medical test order form for healthcare practitioners to request various diagnostic tests including hematology, urine, microbiology, and specialized screenings.
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Medical Power Of Attorney
PDF template
Legal document authorizing a designated agent to make medical decisions on behalf of a patient who is a minor or incapacitated adult.
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Outpatient Order Form For Procedural Visits Only (PVO)
PDF template
Medical order form for requesting specific tests, procedures, and services at a healthcare facility for outpatient visits.
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Outpatient Physician Requisition Form
PDF template
A medical form used to request various diagnostic tests and surgical clearance for outpatient medical services.
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Outpatient Referral Form
PDF template
A comprehensive referral form for patients seeking outpatient services at Children's Hospital Los Angeles, collecting physician, patient, clinical, and insurance information.
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Outpatient Referral Form
PDF template
Medical referral form for patients seeking outpatient services at Children's Hospital Los Angeles.
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Legacy Rehabilitation Services Referral Form
PDF template
Medical referral form for rehabilitation services across multiple Legacy Health locations in Oregon and Washington.
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OUTPATIENT THERAPY PATIENT INTAKE FORM
PDF template
A comprehensive form for collecting patient medical information, injury history, and current health status for outpatient therapy services.
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Outrigger (Paddling And Certification) 2021
PDF template
Guidelines for using Outrigger Canoes at TRRA, including membership requirements, safety protocols, and necessary documentation.
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Outside Employment Waiver Form
PDF template
A form for city employees to request permission for outside employment and waive city liability for potential injuries or incidents.
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Outside Lab Test Protocol
PDF template
Protocol for collecting, labeling, and shipping outside laboratory test samples at a veterinary healthcare facility.
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Doniphan County Fair Overnight Consent Form
PDF template
Consent form for 4-H youth to stay overnight at the county fair, requiring parental permission and cooperation with adult supervisors.
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Overseas Treatment Benefit Application Form 2024
PDF template
Application form for members seeking medical treatment coverage outside their home country under the Executive and Comprehensive Plans.
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Referral Form
PDF template
A medical referral form for veterinary patients detailing clinical information and diagnostic history.
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Referral Form
PDF template
A comprehensive medical referral form for veterinary patients, capturing detailed patient and clinical information for specialist consultation.
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MDC 0044 Owner Consent Form
PDF template
A legal document authorizing a designated party to collect payments and execute documents for a specific property.
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Accident Report Form
PDF template
A comprehensive form for documenting transportation-related accidents, including provider, member, and incident details.
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Pre Authorization Form Revision
PDF template
Notice of revision to the pre-authorization/prior approval request form with new form number and submission guidelines.
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Emergency Medical Form
PDF template
A form enabling parents to authorize emergency medical treatment for children when parents cannot be reached during youth athletic activities.
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Risk Assessment Detail
PDF template
Detailed risk assessment document analyzing inherent and residual risks for sales and revenue transactions
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Risk Assessment Detail
PDF template
Detailed risk assessment document analyzing inherent and residual risks for sales and revenue transactions
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PA CARE Partnership Permission To Contact Form
PDF template
A form for obtaining consent from youth and caregivers to participate in a service quality improvement study across multiple Pennsylvania counties.
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Activity Participation Waiver
PDF template
A comprehensive liability waiver for university-sponsored activities covering risks, health certification, policy compliance, and legal release
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Consent And Waiver
PDF template
A legal document for obtaining consent from parents and minors aged 14+ for guardian appointment proceedings.
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PAC Physical Examination Form
PDF template
Comprehensive medical assessment form for documenting a child's physical health, medical history, and screening results.
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IHCP Prior Authorization Request Form Instructions
PDF template
Detailed instructions for completing a prior authorization request form for Indiana Health Coverage Programs, covering submission requirements and field details.
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New Patient Intake Form
PDF template
Comprehensive medical form for new patients to document pain history, symptoms, and pain characteristics for pain management assessment.
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Prior Authorization Form
PDF template
Comprehensive instructions for completing a Medicaid prior authorization request form with detailed field guidance.
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Imaging Consultation Services Form
PDF template
Medical imaging consultation form for patient radiographic services, including patient and referral information, consent, and fee schedule.
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Notarized Parental Consent Form
PDF template
A form allowing parents to grant permission for a minor to travel and authorize medical decisions during a mission project.
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Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, detailing patient and pharmacy information for insurance processing.
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Paperwork At The Sign In Desk Lesson Plan
PDF template
A training document for practicing healthcare office sign-in procedures, focusing on HIPAA and Consent to Treat forms.
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PAPERWORK REQUEST FORM
PDF template
A form for requesting medical paperwork with payment options and submission methods for Leawood Pediatrics.
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PAP SLIDE SUBMISSION FORM
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A form for submitting gynecologic cytology slides for pathology review and analysis.
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Activity Consent Form And Approval By Parent Or Legal Guardian
PDF template
A comprehensive form for parents/guardians to provide consent and medical information for a child's participation in an activity or program.
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School Parental Consent Form (Grades PK 12)
PDF template
A comprehensive form for collecting student medical, contact, and insurance information for school admission purposes.
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Parental Permission Form Process Of Early Word Learning
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A consent form for a University of Houston research project studying how children learn new words across different languages.
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ParentGuardian Blood Donation Consent Form
PDF template
A form providing information and seeking parental consent for blood donation by 16-year-old students, explaining the donation process and potential risks.
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ParentGuardian Consent Medical Release Form
PDF template
A consent and medical release form for minors visiting Tulane University as overnight guests, requiring parental permission and emergency contact information.
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Special Education Medicaid Initiative (SEMI) Parental Consent Form
PDF template
Consent form allowing school districts to bill Medicaid for special education services provided to students with individualized education programs.
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Parental Consent Form
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A consent form for parents or legal guardians to authorize a minor's volunteer participation with Basset Hound Rescue of Southern California.
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ParentGuardian Consent To Submission Terms And Conditions On Behalf Of Minor
PDF template
Consent form for parents/guardians to allow minors to submit work to the University of North Georgia's Modern Language Day virtual exhibition
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Parental Consent Form
PDF template
A consent form for parents to authorize counseling services for their child at the University of North Texas Counseling and Testing Services.
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Parental Consent Form For Drug Testing
PDF template
A consent form allowing parental permission for drug and alcohol testing of a minor, typically for school or welfare purposes.
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PARENTAL CONSENT FORM FOR YOUTH VOLUNTEERS
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A legal document allowing parents to consent to their child's volunteer work with Goodwill Industries-Suncoast, Inc. and providing medical authorization.
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Parental Consent Form
PDF template
A consent form allowing Penquis Transportation Brokerage to transport minors through various transportation methods without an approved adult present.
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Parental Consent Form
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A consent form for parents to allow children to participate in a research study assessing the PAWS University summer program learning components.
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CONSENT FORM
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Consent form for student participation in a chronic disease self-management educational program designed to support teen health and wellness.
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Parental Consent Form
PDF template
Legal document allowing underage volunteers to participate in Greater Huntsville Humane Society programs with parental consent and media authorization.
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Parental Consent For Child To Participate In A Research Study
PDF template
A template document for obtaining parental consent for a child's participation in a research study at Smith College.
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Youth Citizen Of The Year ParentalGuardian Consent Form
PDF template
Parental consent form for nominating a youth for citizenship award, allowing media documentation and public recognition.
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Parental Guardian Consent Form Waiver Of Liability
PDF template
A consent form allowing a parent or guardian to add minor children to a primary member's fitness center membership while waiving liability
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Informed ConsentAssent For Participation In Research
PDF template
Research study exploring factors that increase STEM career interest among rural middle school students through surveys, interviews, and focus groups.
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ParentLegal Guardian Consent
PDF template
Consent form for parents to allow their child to participate in a research training program funded by NIH and share application data for research purposes.
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Parental Consent Health Declaration Form
PDF template
A comprehensive form for parental consent and emergency contact information for students traveling to educational programs.
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Utah State Board Of Education ParentGuardian Consent Form Maturation Instruction
PDF template
Parental consent form for student participation in puberty and reproductive health education program as outlined by Utah State Board of Education.
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Parent Consent Form To Travel Abroad
PDF template
A document granting permission for a child to travel internationally with or without parents, providing legal authorization and emergency contact details.
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Parent Consent Form For Youth Volunteers
PDF template
A consent form for parents to authorize their children under 18 to volunteer with the City of Grand Prairie.
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CSD Parent Contact Form
PDF template
A form for parents to provide contact information for potential participation in research studies related to children.
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Parent Guardian Consent And Emergency Contact Form
PDF template
A consent form for parents or guardians to authorize child participation in a program, provide emergency contact information, and authorize pickup contacts.
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ParentGuardian Consent Form
PDF template
Consent form for parents/guardians allowing minors aged 16-17 to participate in firefighting training programs with full acknowledgment of potential risks.
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Sample ParentGuardian Permission Document
PDF template
A template document for obtaining parental consent for a child's participation in a research study at a university.
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PARENTGUARDIANSTUDENT INFORMATION FORM
PDF template
A comprehensive form for collecting student, parent, and guardian contact and medical insurance details for athletic purposes.
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Parental Informed Consent, Waiver Release
PDF template
Parental consent form for students participating in a mathematics enhancement program at California State University, Northridge.
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Insurance Information
PDF template
Guidelines for sport-related injury insurance claims and reporting procedures for students at Chattanooga State.
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St. James Preschool ParentPhysician Medical Form 20212022
PDF template
Medical form for child enrollment at St. James Preschool, requiring parent and physician details and health verification.
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Accessible Parking Form
PDF template
Application form for students, faculty, and staff to obtain an accessible parking permit due to mobility impairments or medical conditions.
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Parking Accommodation Medical Form
PDF template
Medical form used to verify disability status and facilitate parking accommodations at the University of Michigan under ADAAA guidelines.
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USDA National Food Study Consent Form
PDF template
Consent document for a USDA-sponsored study collecting information about household food purchasing, consumption, and dietary habits.
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Sona Systems For Participants Frequently Asked Questions
PDF template
A comprehensive guide for students using the Sona Systems research participation platform, covering account creation, study signup, and parental consent requirements.
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Participant Information Sheet And Consent Form Templates
PDF template
A comprehensive template and guidance document for researchers developing participant information sheets and consent forms for research studies.
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Participant Medical Form
PDF template
Medical form for children's summer recreational program documenting health status and medical clearance from a licensed healthcare provider.
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Participant Information Medical Form
PDF template
Comprehensive form for collecting participant and parent/guardian information for performing arts activities
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Participant Release And Waiver Of Liability Form
PDF template
Legal document releasing Optimist Club from liability for a minor participant's activities and potential injuries.
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ParticipantVisitor Liability Release And Waiver Form
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A liability release form for participants and visitors of Saving Grace Animals for Adoption, a non-profit dog rescue organization.
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Participant Liability Release, Hold Harmless And Indemnification Form
PDF template
A legal document releasing liability for participants in activities at the Brian Bent Memorial Aquatics Complex under Coronado Unified School District supervision.
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Participation Agreement And Waiver Form
PDF template
Legal document releasing liability for participation in a program or activity, signed by parent or guardian on behalf of a participant.
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Participation Agreement And Waiver Form
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Legal document releasing liability for participation in a program or activity, typically used by organizations to protect against potential legal claims.
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Participant Agreement Form
PDF template
A legal document outlining participant consent, risk acknowledgment, and liability release for an organized activity or program.
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Risk, Incentives, And Contracts Partnerships In Rio De Janeiro, 18701891
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A research paper examining partnership contracts in late 19th-century Brazil, analyzing the impacts of liability structures on business partnerships.
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Standing Order RequestCancellation Form
PDF template
A form for requesting medical transportation services with options for service type, pickup/dropoff details, and special needs accommodation.
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Passport Consent Form
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Consent form for foster youth and unaccompanied homeless youth seeking educational assistance and scholarships in Washington state.
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Patient Referral Form
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A medical referral form for scheduling a Modified Barium Swallow Study with specific documentation requirements.
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Checklist For Pathology Consultation
PDF template
A detailed checklist for submitting materials and documentation for pathology consultation at MD Anderson Cancer Center.
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Pathology Consultation Request
PDF template
A comprehensive form for submitting pathology consultation materials and patient information for diagnostic review.
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Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training across various subspecialties.
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Pathology Consultation Request
PDF template
A detailed medical form for submitting pathology specimens and requesting consultation from Mayo Clinic Laboratories.
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Pathology Specimen Transport Guide
PDF template
Comprehensive guide for properly handling and transporting pathology specimens to RPCI Laboratories with specific packaging and labeling requirements.
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PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive form for collecting patient personal and medical information, including previous physicians, pharmacies, and insurance details.
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Patient Information Medical History Form
PDF template
Comprehensive medical intake form for collecting patient personal and contact information, medical history, and demographic details.
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Patient Billing Inquiry Form
PDF template
A form for patients to submit billing questions, statements, and account-related inquiries to the Finance Department.
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Patient Complaint Form
PDF template
A form for patients to file complaints about privacy policies or procedures at California State University, East Bay Student Health & Counseling Services.
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Patient Confidential Medical History Form
PDF template
Comprehensive patient medical history form gathering information about health status, medical conditions, medications, and family history.
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Consent Form
PDF template
A legal document allowing publication of medical information for educational purposes with explicit privacy and consent guidelines.
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Patient Consent Form For Collection Use And Disclosure Information
PDF template
A comprehensive consent form outlining how a dental practice collects, uses, and protects patient personal information.
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CONSENT TO PUBLISH FORM
PDF template
A form for obtaining consent from patients or study participants to publish their identifiable details in a medical journal or research article.
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Patient Contact Form
PDF template
Form for patients to authorize contact methods and designate individuals who may receive medical information.
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Patient Contact Form
PDF template
Comprehensive form for collecting patient personal information, contact details, medical history, and symptom assessment.
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Demographic Insurance Form
PDF template
Comprehensive form for collecting patient personal, emergency contact, medical provider, and insurance information.
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Patient Demographic Insurance Billing Form
PDF template
A comprehensive form for patient demographic information, insurance details, and billing for diagnostic services.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient demographic and contact information for medical practice
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Patient Intake Form
PDF template
Comprehensive patient registration and medical history form for Swank Chiropractic Sports Medicine & Wellness Center
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Patient Medical History Form
PDF template
Comprehensive medical history form for patient intake, covering personal and family medical information, symptoms, and lifestyle factors.
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CONSENT FORM
PDF template
Legal document granting Massachusetts Medical Society permission to publish patient medical material anonymously in The New England Journal of Medicine.
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Patient Interview Form
PDF template
Comprehensive patient intake form collecting personal, demographic, and medical contact information for healthcare providers.
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MEDICAL FORM
PDF template
A comprehensive medical form for collecting patient personal information, contact details, and healthcare status.
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PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, insurance, and medical history information for healthcare providers.
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Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient personal information, medical history, medication details, and allergies for healthcare purposes.
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PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting patient personal, medical, insurance, and contact information for healthcare purposes.
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Initial Intake Form
PDF template
Comprehensive form for collecting patient personal, contact, insurance, and medical visit information.
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ONE Program Patient Intake Form
PDF template
Comprehensive intake form for assessing patient risk factors and medical history related to opioid medication use
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PATIENT INTAKE FORM
PDF template
Comprehensive patient intake form for chiropractic services, collecting personal, medical, and insurance information.
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Family Medicine Patient Intake Form
PDF template
Comprehensive medical intake form for patients to report current symptoms, health concerns, and medical history
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Chase Lay, MD Associates Patient Information Form
PDF template
Comprehensive medical history and contact form for facial plastic surgery consultation
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Operation Sight Intake Form
PDF template
Form for documenting details of charitable cataract surgery cases under the ASCRS Foundation's Operation Sight program.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, medical, and health history information.
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Patient Intake Form
PDF template
Comprehensive patient registration form for medical application requiring personal, contact, and insurance information for OMMA (Oklahoma Medical Marijuana Authority) submission.
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PATIENT INTAKE FORM
PDF template
Comprehensive medical form for collecting patient health history, personal background, and lifestyle information.
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PATIENT INTAKE FORM
PDF template
A standard form for collecting patient personal, contact, and medical visit information for healthcare providers.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient health history, contact information, and medical details.
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PTOT Patient Intake Form
PDF template
A comprehensive medical intake form for patients seeking physical, occupational, or speech therapy services at Beauregard Memorial Hospital.
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Patient Intake Form
PDF template
Comprehensive patient information form for dental practice intake and demographic data collection.
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Patient Data Form
PDF template
Comprehensive patient demographic and personal information collection form for healthcare services.
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Patient Intake Form
PDF template
Comprehensive medical intake form collecting patient health history, personal information, and consent for treatment.
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Patient Intake Form
PDF template
Comprehensive medical intake form for a plastic surgery practice collecting patient personal, contact, and referral information.
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Patient Intake And History Form
PDF template
Comprehensive patient medical intake form for collecting personal and health history information at Meeker Family Health Center.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient health history, current symptoms, work status, and personal medical background.
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Patient Information Form
PDF template
Comprehensive medical intake form collecting patient personal details, medical history, and insurance information.
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PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form collecting patient personal information, health history, family medical background, and current health concerns.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive form for collecting new patient personal, medical, insurance, and emergency contact information.
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Medical History Form
PDF template
Comprehensive medical history form capturing patient health details, medical conditions, and personal health information.
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PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical history form for collecting patient personal, medical, and family health information.
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Patient Medical History Form
PDF template
Comprehensive medical history form for patients to document health conditions, medications, allergies, and family medical history.
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Patient Medical History Form Pre Anesthesia Clinic
PDF template
Comprehensive medical history questionnaire for patients preparing for surgical procedures, collecting detailed health information across multiple medical domains.
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Patient Referral Form
PDF template
A comprehensive form for patients seeking specialist medical referrals through We Care Manatee health services.
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Patient Referral Form
PDF template
A comprehensive form for veterinarians to refer patients to VCA California Veterinary Specialists for specialized medical services.
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PATIENT Refund Request Form
PDF template
A form for patients to request a refund for medical services, to be submitted to patient accounts.
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Clinic Patient Registration Form
PDF template
A comprehensive medical form for collecting patient personal, contact, and health information for clinic registration purposes.
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PATIENT REGISTRATION FORM
PDF template
Comprehensive form for collecting patient personal, contact, insurance, and payment responsibility information for medical or dental services.
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Patient Registration Form
PDF template
Comprehensive patient information and insurance registration document for healthcare services.
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Patient Registration Form (ECW)
PDF template
A comprehensive form for collecting patient personal, contact, and emergency information for healthcare providers.
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Patient Registration Form
PDF template
A form for collecting patient insurance details and establishing financial responsibilities for medical services.
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Patient Registration Form
PDF template
Comprehensive form for collecting patient personal information, contact details, insurance, and demographic data for healthcare providers.
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Patient Registration Form
PDF template
Comprehensive form for collecting patient personal, contact, employment, emergency contact, and insurance information for healthcare providers.
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ECRMC Patient Feedback Form
PDF template
A form for patients to provide feedback or file a complaint about their healthcare experience at El Centro Regional Medical Center (ECRMC).
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PATIENT STANDING ORDER REQUEST FORM
PDF template
A medical form for requesting laboratory tests with options for one-time and standing orders from NorthShore University HealthSystem.
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PATIENT STANDING ORDER REQUEST FORM
PDF template
A form for physicians to submit laboratory test orders for patients, with options for one-time and standing orders.
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PHAS Empowered Patient Online Toolkit Insurance Form
PDF template
A comprehensive document for collecting and organizing personal insurance details across multiple insurance types and providers.
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Patient Voice Feedback Form
PDF template
A form for patients to provide feedback, compliments, or concerns about healthcare services and staff at NEW Health facilities.
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Fort Berthold Library Borrowing Privileges Form
PDF template
Application form for library borrowing privileges with additional parental internet consent section for minors using library resources.
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PATS Verification Of Attendance
PDF template
A form for documenting patient travel and accommodation details for reimbursement and healthcare travel support.
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Medical Form A And B PAX Abroad
PDF template
Comprehensive medical history and physical examination form for foreign exchange student applicants, to be completed by a licensed physician.
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Paxman Hub Enrollment Form
PDF template
Comprehensive enrollment form for patient information, insurance, and treatment details for Paxman medical services.
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Payment Authorization Form
PDF template
A form for students to authorize payments and grant third-party access to student financial information at Solano Community College.
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Payment Plan Agreement
PDF template
A formal agreement outlining payment terms for medical services at Partnership Health Center, establishing a schedule for resolving outstanding medical account balances.
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Self Direction Payment Request Form (PRF)
PDF template
Form for requesting payment for self-directed services within a specific budget and waiver program, with specific submission requirements.
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ACA Waiver Form
PDF template
Form for employees to waive health and prescription drug coverage under employer-sponsored health plans, in compliance with the Affordable Care Act's Employer Shared Responsibility mandate.
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Release And Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
PDF template
Legal document releasing liability for participants in Porsche Club of America events and activities
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Media Release
PDF template
A consent form for photographing, recording, and using media content of individuals participating in college events.
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PhysicianS Medical Evaluation For Assisted Living
PDF template
Comprehensive medical assessment form for patients seeking admission to or continuing care in an assisted living facility.
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MO HealthNet Primary Care Health Home Discharge Protocol
PDF template
Protocol for discharging patients from a Primary Care Health Home, outlining procedures for submission and communication of discharge forms.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for new patients seeking primary care at Alice Peck Day Memorial Hospital's multi-specialty clinic.
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ParentGuardianCaretaker Consent Form
PDF template
Consent form for parents/guardians allowing children to participate in a Strength & Resiliency Workshop addressing trauma and resilience.
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Community Choices Waiver Participant Direction Employer Agreement
PDF template
A legal document outlining the responsibilities and guidelines for participants managing their own healthcare services under the Community Choices Waiver program.
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PATIENT MEDICAL HISTORY FORM
PDF template
A comprehensive medical form for collecting patient health information, medical conditions, and current medications.
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Student Fee Waiver Form
PDF template
A form for families to request fee waivers for school-related expenses based on income guidelines.
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Pre Travel Form
PDF template
Comprehensive form for collecting personal and travel details to assess health risks and preparation for international travel.
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Child Life Fellowship Application Form
PDF template
Application form for candidates seeking a fellowship in child life services at UNC Hospitals, requiring professional and academic details.
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Referral Form UNC Hospitals Dental Clinic
PDF template
A specialized referral form for patients with specific medical conditions requiring dental care at UNC Hospitals Dental Clinic.
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Rheumatology New Patient ReferralConsultation
PDF template
A comprehensive referral form for new patients seeking rheumatology consultation, including patient and provider information.
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Patient Demographic Form
PDF template
Comprehensive form for collecting patient personal, contact, and medical referral information for healthcare providers.
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Sleep Center Referral Form
PDF template
Medical referral form for sleep disorder diagnosis and testing, used by healthcare providers to request sleep studies and consultations.
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REQUISITION PEACE DIAGNOSTIC IMAGING
PDF template
Medical form for patient information, clinical details, and procedure requisition for diagnostic imaging services.
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Emergency Patient Referral Form
PDF template
A comprehensive form for referring a pet patient to an emergency veterinary clinic, capturing veterinarian, client, and patient details.
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Medical History Form Forma De Historia Mdica
PDF template
A bilingual medical history form for collecting pediatric patient health information and medical background.
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Incoming Referral Form
PDF template
A comprehensive form for collecting patient demographics, insurance details, and referral information for medical practices.
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Pediatric Health Risk Assessment Form
PDF template
A health risk assessment form for pediatric patients under Partnership HealthPlan of California to understand a child's health and wellness needs.
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Pediatric Health Risk Assessment Form
PDF template
A health assessment form to collect information about a child's health, wellness needs, and potential difficulties in daily activities.
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Pediatric Patient Intake Form
PDF template
Comprehensive medical intake form for pediatric patients to collect personal, insurance, and medical history information.
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Pediatric Referral Form
PDF template
Comprehensive medical form for pediatric patients seeking dermatology consultation, capturing patient information, referral details, and specific skin condition assessments.
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PEDIATRIC PATIENT REFERRAL FORM
PDF template
A medical form used to collect patient information and referral details for pediatric medical consultation.
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Ear, Nose Throat Consultants Tongue Tie Medical History Form
PDF template
Comprehensive medical history form for pediatric patient evaluation focused on tongue tie assessment and related medical conditions.
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Pediatric Vaccine Order Form
PDF template
Comprehensive order form listing various pediatric vaccines with their CPT codes, manufacturers, and packaging details.
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Physician Order Form For Pediatric Imaging Services
PDF template
A comprehensive form for ordering pediatric diagnostic imaging services with patient and clinical details
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Post Employment Health Plan (PEHP) Claim Form
PDF template
Form for requesting health plan reimbursements for medical expenses or insurance premiums after employment separation.
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PELVIC EXAMINATIONS CONSENT FORM
PDF template
A medical consent form for patients undergoing pelvic examinations, detailing the nature of the examination and patient consent.
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PELVIC EXAMINATIONS CONSENT FORM
PDF template
A medical consent form for patients undergoing pelvic examinations, detailing the nature of the examination and patient consent.
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GUIDANCE FOR CLUB APPROVED CLINICS FOR COMPLIANCE WITH THE AMERICAN CLUB PRE EMPLOYMENT MEDICAL EXAM
PDF template
Guidance document for clinics conducting pre-employment medical examinations for seafarers working on American Club vessels.
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Customer Penalty Waiver Form
PDF template
A form allowing water and sewer customers to request a one-time waiver of a 10% late payment penalty under specific conditions.
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CONSENT FORM
PDF template
A consent form authorizing The Church Pension Fund to share benefit information with specified individuals.
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Incident Report Form Percutaneous Injury Bloodborne Pathogen AndOr Body Fluid Exposure
PDF template
Form for documenting workplace or medical training-related incidents involving potential bloodborne pathogen exposure or bodily fluid contact.
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Perinatal Hepatitis B Prevention Initial Report Delivery Form
PDF template
A medical form for reporting and tracking infants born to mothers with Hepatitis B surface antigen positive status.
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Department Of Periodontics Referral Form
PDF template
Medical referral form for periodontal examination and treatment, used to collect patient dental information and treatment history.
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WAIVER OF LIABILITYPERMISSIONMEDICAL RELEASE FORM
PDF template
A comprehensive form for students staying overnight at Smith College, requiring parental consent and liability release.
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Permission Form For Youth Outing
PDF template
A form allowing parents/guardians to grant permission for youth to attend an outing and provide medical consent in case of emergency.
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PermissionWaiver Form For The Salvation Army Residential Camps
PDF template
A legal document granting The Salvation Army permission to use participant's media and likeness for various purposes while releasing the organization from related claims.
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CLAIM FORM
PDF template
Insurance claim form for students with international visa status, covering injury and medical claims.
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Personal Data Protection Act Consent Form
PDF template
A consent form for collecting and using personal data in compliance with the Personal Data Protection Act by the Chinese Swimming Club.
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PATIENT INJURYMEDICAL HISTORY FORM
PDF template
A comprehensive form documenting patient details and medical information following a vehicle accident.
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Personal Liability Release Form
PDF template
Liability release and consent form for student participants at the North Carolina Technology Student Association Regional Competitive Events Conference.
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Personal Medical History Form
PDF template
Comprehensive medical history form for students to document health conditions, allergies, and medical background for program enrollment.
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SCVSAREMRU Personal Release
PDF template
Legal document releasing liability for participants in search and rescue training and activities with Snohomish County Volunteer Search and Rescue and Everett Mountain Rescue Unit.
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Personal Survey Form
PDF template
Form for documenting radiation exposure and contamination during radioactive material handling.
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Assumption Of Risk, Waiver And Release Of Liability, And Indemnity Agreement
PDF template
Legal document outlining risk assumption and liability release for personal training services and facility use.
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PERSONNEL SCREENING, CONSENT AND AUTHORIZATION FORM
PDF template
A document used for collecting consent and authorization for personnel screening and background checks.
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New York City Local Law 37 Agency Waiver Form
PDF template
A form for agencies to request a waiver for pesticide application in specific locations, detailing infestation circumstances and alternative methods considered.
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Patient Intake Form
PDF template
A comprehensive medical intake form for patients undergoing PET/CT imaging, collecting patient medical history, current health status, and pre-scan details.
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Petition To Return Health Evaluation Form
PDF template
Form for students seeking to return to UNC Charlotte after a medical withdrawal, requiring health provider documentation of recovery and readiness to resume studies.
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Pet Policies And Waiver Form
PDF template
Comprehensive waiver and policy document for guests bringing pets to Eldorado Resort, outlining rules, fees, and responsibilities of pet owners.
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Pet Agreement Form Rental
PDF template
A legal document outlining tenant responsibilities and conditions for keeping a pet in a rental property.
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Pet Tribute
PDF template
A donation form to honor a pet with a tribute in the Whispering Garden at the KSU College of Veterinary Medicine.
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PE Waiver Form And Information
PDF template
Form for students in grades 1-8 to request exemption from physical education classes based on specific criteria
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Physical Education Waiver
PDF template
Medical form for students seeking exemption from physical education classes based on health provider's certification of physical limitations.
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Paws For Life USA, Inc Client Application Part B Medical History Form
PDF template
Medical history form for clients seeking service dog training, requiring physician documentation of patient's medical conditions and authorization for information release.
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14th International Conference On Preimplantation Genetic Diagnosis Hotel Booking Form
PDF template
Hotel reservation form for attendees of the 14th International Conference on Preimplantation Genetic Diagnosis in Chicago, USA.
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Inventory Of Radioactive Sealed Sources Devices
PDF template
A comprehensive form for tracking and documenting radioactive sealed sources and devices for regulatory compliance.
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Risk Assessment Form
PDF template
A comprehensive form for assessing and documenting potential risks associated with academic fieldwork and research activities.
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Informed Consent, Release Agreement, And Authorization
PDF template
Legal document for participant consent and medical authorization for Boy Scouts of America activities, covering emergency medical treatment and risk acknowledgment.
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Consent To Disclose Personal Health Information
PDF template
A legal form authorizing the disclosure of personal health information in compliance with the Personal Health Information Protection Act (PHIPA)
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Photo And Media Release Form
PDF template
Legal document granting permission for a child care center to use photographs of a child for authorized purposes.
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Media Release Form
PDF template
A consent form allowing University of Central Florida to use participant's images, recordings, and likeness for various purposes.
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Photo Consent Form
PDF template
Legal form granting permission for use of personal photographs by a municipal organization.
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Photograph Inventory Form
PDF template
A form for documenting and tracking patient photographs in a clinical research setting, including details about photographic documentation of medical examinations.
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Photography And Videography Consent Form
PDF template
Legal document granting Samford University rights to use an individual's likeness and media for promotional purposes.
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Consent And Media Release Form
PDF template
A consent form allowing UVU to use photographs, audio, and video recordings for educational and promotional purposes.
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Photography Consent Form Template Australia
PDF template
A template form for obtaining consent and releasing rights for photographic images in Australia.
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Standard Media Release Form
PDF template
Legal document granting University of Kentucky permission to use an individual's media and likeness for various promotional and educational purposes.
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Media Release Form
PDF template
A form authorizing the use of photographs and videos of congregation members in various media platforms.
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Media Release Form
PDF template
A form granting permission for the library to use an individual's photo or media for promotional and educational purposes.
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Media Release Form
PDF template
Legal form granting permission for the American College of Prosthodontists to use an individual's likeness in various media and promotional materials.
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Photo And Media Release Form
PDF template
A legal document granting Pajama Program permission to use an individual's likeness for promotional purposes without compensation.
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PhotoVideo Media Release Form
PDF template
A legal document granting Mississippi State University permission to use an individual's likeness in photographs, videos, and other media productions.
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Photo Submission Release Form
PDF template
A form for photographers to submit photos of Fluvanna County for use in county publications, website, and social media.
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Release And Waiver For Use Of Visual Or Audio Recordings
PDF template
Legal document granting Riverside Community College District permission to use and reproduce submitted visual or audio materials.
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MEDIA RELEASE FORM
PDF template
A legal document granting St. George's University permission to use an individual's images, footage, audio, and comments for various marketing and communication purposes.
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MEDIA RELEASE FORM PHOTOGRAPHS ANDOR VIDEO
PDF template
A legal document granting Marymount Manhattan College permission to use photographs or video of an individual for various media purposes.
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Phoenix PBM Pre Authorization Form
PDF template
A form for healthcare providers to request pharmacy benefit pre-authorization for medication coverage through Phoenix Benefits Management.
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Student Health Center Document
PDF template
Document related to student health services at North Carolina A&T State University.
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School Sports Pre Participation Examination Part 1
PDF template
Medical history and physical examination form for students participating in school sports activities.
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Pre Participation Physical Evaluation Form
PDF template
Medical form for evaluating a student's fitness to participate in school sports and athletic activities
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Required NYS School Health Examination Form
PDF template
Comprehensive health examination form for students in New York State, covering medical history and health assessments.
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Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for athletes to assess physical fitness and health status prior to participation in sports activities.
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PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for NCAA athletes and students, documenting health history and current medical status.
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Physical Examination Form
PDF template
Comprehensive medical examination form for students, including health screening and sports clearance details.
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NORTH CEDAR COMMUNITY SCHOOL DISTRICT HEALTH SERVICES MEDICAL EXAMINATION FORM
PDF template
Comprehensive medical examination form for students, capturing health history, physical examination details, and screening information.
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Physical Examination Form
PDF template
Medical form documenting a student's health status and physical examination required by Saint Louis Archdiocese Health Advisory Committee for school enrollment.
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Physical Examination Form
PDF template
Comprehensive medical examination form for students, including general health assessment and athletic participation clearance.
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Physical Examination Form
PDF template
Comprehensive physical examination form for medical clearance and athletics participation at Virginia Military Institute
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School Sports Pre Participation Examination Part 1 Student Or Parent Completes
PDF template
Medical history and examination form required for student-athletes participating in school sports in Oregon
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Physical Examination Form
PDF template
A form to be completed by a healthcare provider detailing a participant's physical examination and medical details.
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Physical Examination Form For Driver
PDF template
Medical examination form to assess a driver's physical fitness and ability to safely operate a vehicle, specifically for school bus drivers.
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Physical Examination Form For Driver Applicant
PDF template
A comprehensive medical examination form to assess a school bus driver's physical fitness and ability to safely operate a vehicle.
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PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical evaluation form for students participating in school sports activities
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YMCA Camp Takodah PHYSICAL EXAMINATION FORM
PDF template
Medical form for assessing a child's health and fitness for participation in summer camp activities.
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Alabama Independent School Association Physical Examination Form
PDF template
A comprehensive medical examination form required for students participating in interscholastic athletics in Alabama.
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Nursing Student Health Examination Form
PDF template
A comprehensive health examination form for nursing students documenting medical clearance, TB testing, and immunization records.
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Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical screening form for assessing an individual's physical health and fitness for participation in activities.
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HISTORY FORM
PDF template
Comprehensive medical history and health screening form for athletes to complete prior to participation in sports activities.
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ALABAMA INDEPENDENT SCHOOL ASSOCIATION PHYSICAL EXAMINATION FORM
PDF template
A comprehensive medical examination form for students participating in interscholastic athletics, completed by a physician to certify student fitness for sports.
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Preparticipation Physical Evaluation Medical History
PDF template
A comprehensive medical history form required for student athletes to participate in school sports activities, collecting health information and parental consent.
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Arizona Interscholastic Association Annual Preparticipation Physical Evaluation
PDF template
Medical screening form for student-athletes to assess physical fitness and health conditions prior to sports participation.
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Physical Examination Form Pre K Grade 5
PDF template
Medical form for recording student health history, physical examination details, and vaccination records for pre-kindergarten through fifth-grade students.
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Student Physical Education Medical Clearance Form
PDF template
Medical form for assessing student's physical capabilities and participation in physical education activities.
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PhysicianS Approval Form
PDF template
A form requiring physician verification of a patient's medical fitness to participate in physical activity programs at a fitness center
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PhysicianS Approval Form
PDF template
A medical form for health verification and clearance for participation in fitness programs, required for members with specific health conditions or over 70 years old.
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Physician Authorization Form
PDF template
Medical form for documenting participant health status and program participation eligibility for special recreation services.
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Occupational Therapy Consent Form
PDF template
A consent form for parents/guardians to authorize occupational therapy assessment and information release for a child.
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PhysicianS Evaluation Form
PDF template
Medical assessment form for individuals with developmental disabilities, documenting health status, diagnoses, medications, and medical support needs.
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Physician Examination Form
PDF template
A comprehensive medical form for camp participation requiring detailed health assessment by a licensed medical professional.
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Physician Referral Form
PDF template
A medical referral form for patients being considered for Transcranial Magnetic Stimulation (TMS) therapy, primarily for Major Depressive Disorder.
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Home Care Referral Form
PDF template
Comprehensive referral form for home healthcare services, collecting patient information, medical history, and service requests.
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PhysicianS Referral Form
PDF template
A medical form for physicians to refer patients to a fitness evaluation and preventive exercise program at McHenry County College.
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Physician Report Form
PDF template
A comprehensive medical examination form for students entering healthcare training programs to verify physical fitness and health status.
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In Home Care Permit Medical Affidavit Form
PDF template
A medical affidavit form used to apply for residential parking permits for individuals requiring healthcare-related parking accommodations.
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HEALTH FORM
PDF template
Medical form for assessing a child's fitness to participate in camp activities, documenting health history, immunizations, and physical examination details.
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PIAB Medical Assessment Form (Form B)
PDF template
A standardized medical report template used by Ireland's Personal Injuries Assessment Board (PIAB) for documenting medical details in personal injury compensation claims.
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ConsentRelease Of Information Form
PDF template
A form allowing parents or guardians to provide consent for sharing child's information between agencies for comprehensive services.
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Media Release Form
PDF template
A legal document granting permission for an organization to photograph, record, and use an individual's image and likeness for publicity and marketing purposes.
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Patient Interview Form
PDF template
Comprehensive medical intake form for patient demographics, medical history, and diagnostic information for gastroenterology clinic.
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Patient Interview Form
PDF template
Comprehensive medical form for collecting patient demographic, contact, medical history, and personal health information.
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CDCI Media Release Form
PDF template
A consent form for recording and sharing media by the Center on Disability and Community Inclusion at the University of Vermont.
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Notice Of Claim For Short Term Disability Benefits
PDF template
A form for employees to file a claim for short-term disability benefits with insurance details and medical information.
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S2 Treatment Provider Declaration Form
PDF template
A form for healthcare providers to document details of planned medical treatment for patients seeking cross-border healthcare within the European Economic Area.
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NEW PATIENT INTAKE FORM
PDF template
Comprehensive medical intake form for new patients seeking plastic surgery services at Wang Ambulatory Care Center in Boston.
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Attending PhysicianS Statement Of Disability
PDF template
Medical form used by physicians to document and certify a patient's disability status and work limitations for insurance purposes.
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Hockey Canada Medical Information Sheet
PDF template
A comprehensive medical information and health screening form for hockey players to capture medical history, emergency contacts, and potential health conditions.
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USAV YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
Medical release and emergency contact form for youth and junior volleyball players participating in sanctioned competitions and practices.
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YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A comprehensive medical release and consent form for youth and junior volleyball players, detailing medical information, emergency contacts, and participation permissions.
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Hockey Canada Medical Information Sheet
PDF template
Comprehensive medical information form for hockey players to document health history and potential medical conditions.
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Requisition Form PlexAPRTM
PDF template
A diagnostic test requisition form for PlexAPR testing procedure.
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PM 330 Sterilization Consent Form
PDF template
Instructions and guidelines for completing a sterilization consent form to ensure proper billing and reimbursement.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient demographic, contact, insurance, and referral information for physical therapy services.
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CHILDWARD RELEASE FORM
PDF template
A release form granting Princeton University permission to record and use a child's image and biographical data for non-commercial purposes.
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Family Medical Leave Request Form
PDF template
Form for employees to request leave under the Family and Medical Leave Act for personal or family health reasons.
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Medical History Intake Form
PDF template
Comprehensive medical intake form for collecting patient medical background, current symptoms, and health history.
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Policy 2 107 Creditworthiness And Credit Risk Assessment Policy
PDF template
A policy outlining the process for evaluating creditworthiness of customers and managing credit risk using Dun & Bradstreet services.
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Field Trip Approval Form (CurricularCo CurricularExtra Curricular Activities)
PDF template
A comprehensive form for documenting and obtaining approval for school field trips, including details about travel, supervision, and consent.
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CCMS Non Approved Vendor Source Rodent Importation Policy
PDF template
Policy outlining procedures for importing non-approved vendor mouse lines through sperm in vitro fertilization (IVF) re-derivation at CCMS.
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Policy For Housestaff Travel Reimbursement
PDF template
Policy detailing travel expense reimbursement for medical residents presenting at conferences with CME credits.
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Policy Waiver Request Form
PDF template
A form for requesting exceptions to standard facility booking, payment, and equipment storage policies for event reservations.
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Media Release Form
PDF template
A consent form allowing use of participant's name and image for media purposes related to Poetry Out Loud events.
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POM 821.71 Physical Examination Requirements
PDF template
A personnel operations memorandum establishing physical examination requirements for active duty and Ready Reserve Corps officers and candidates seeking commission in the USPHS Commissioned Corps.
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Patient Discharge Form
PDF template
A form used to document patient discharge details, care instructions, and follow-up services.
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Declaration Of Medical Condition
PDF template
Medical certification form for peace officer candidates in Montana documenting physical qualification for service.
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Post Travel Waiver Request Form
PDF template
A form used to request a waiver for non-standard travel procedures after a trip has been completed, allowing for retroactive travel authorization and expense reimbursement.
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BAHNPIP Monitoring Test Submission Form COMMERCIAL POULTRY
PDF template
A form for commercial poultry testing and monitoring for various avian diseases and health conditions.
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Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
PDF template
Medical examination form for assessing an individual's fitness to participate in sports activities, including comprehensive health screening questions.
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Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM
PDF template
Comprehensive medical evaluation form for athletes to assess physical fitness and potential health risks prior to participation in sports activities.
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Competitor Medical History
PDF template
A comprehensive medical history form for competitors to provide health details for safety and medical screening purposes.
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Medical Form
PDF template
A comprehensive medical history form for event participants, collecting personal health information and emergency contact details.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for collecting patient health information, medical conditions, recent symptoms, and personal details.
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Practice Location Fact Sheet
PDF template
A form for physicians to provide detailed information about their practice location and its alignment with university missions.
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Patient Information And Medical Information Form
PDF template
A comprehensive medical reporting form for documenting patient medical details, demographic information, and disease reporting requirements in Florida.
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Patient Information And Medical Information Form
PDF template
Comprehensive medical reporting form for collecting patient personal, medical, and provider information for health tracking and disease reporting in Florida.
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FCL Pre Authorization Form
PDF template
A medical insurance pre-authorization form for requesting approval of medical procedures and services
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Pre Authorization Form
PDF template
A form for requesting pre-authorization for medical procedures or treatments from GBG Assist insurance provider.
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Admission Request Note
PDF template
A comprehensive form for requesting medical admission and insurance coverage, capturing patient and medical details for hospital admission.
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Pre Authorization Form (PAF)
PDF template
A form used by insured members to request pre-approval for non-emergency hospitalization and medical procedures through Allianz EFU health insurance.
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Pre Authorization Form
PDF template
A form for requesting pre-authorization for medical procedures and treatments through TieCare insurance.
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Pre Authorization Form
PDF template
A form allowing credit card charges for medical services when insurance reimbursement is received.
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Precollege Programs Information And Consent Form
PDF template
A consent and medical information form for students participating in the Fashion Institute of Technology (FIT) Precollege Programs.
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Predetermination Request Form
PDF template
A medical form used to request pre-approval for medical treatments, procedures, or services from a health insurance provider.
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Post Offer Pre Employment Drug Testing Consent Form
PDF template
A consent form for job candidates to agree to drug testing as a condition of employment for safety-sensitive positions in the City of Mt. Vernon.
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PRE EMPLOYMENT DRUG TESTING CONSENT FORM
PDF template
A consent form for job applicants to undergo pre-employment drug screening as a condition of employment.
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PRE EMPLOYMENT DRUG TESTING CONSENT FORM
PDF template
A consent form for job candidates to agree to drug testing as part of the pre-employment screening process at Tektronix.
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Pregnancy Recovery Leave Request Form
PDF template
A form for employees requesting leave to recover from pregnancy-related events who do not qualify for Family Medical Leave.
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Athletic Participation Form
PDF template
A comprehensive medical screening form for students participating in interscholastic athletics, collecting personal and medical information.
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Pre Participation Physical Examination Medical History Form
PDF template
A comprehensive medical history form for students participating in school sports, collecting health information and screening for potential medical concerns.
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PREPARTICIPATION PHYSICAL EVALUATION HISTORY FORM
PDF template
Comprehensive medical history questionnaire for athletes to assess health status and potential medical concerns prior to sports participation.
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PhysicianS PREPOST Bout Exams
PDF template
Medical examination form for athletes participating in boxing, MMA, kickboxing, and elimination tournaments to assess physical fitness for competition.
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Equine Pre Purchase Form
PDF template
Comprehensive veterinary form for prospective horse buyers to document medical history, examination details, and potential additional testing.
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Undergraduate Prerequisite Waiver Form
PDF template
A form allowing students to request waivers for course prerequisites under specific circumstances such as course away, incomplete grades, or study abroad.
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PREREQUISITE WAIVER FORM
PDF template
Form for students seeking to override course prerequisites with faculty approval at California State University San Marcos.
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Prescription Drug Claim Form
PDF template
A form for submitting prescription drug claims to Blue Cross Blue Shield for reimbursement or processing.
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Presentation Authorization Form
PDF template
A form authorizing media recording, publication, and usage rights for a presentation at UNMC (University of Nebraska Medical Center).
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Preventative Health Care Examination Form
PDF template
Medical form for documenting student health history, physical examination, and medical recommendations.
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PCP CHANGE February 2014
PDF template
A form for members of Health Plan of San Mateo (HPSM) health insurance programs to select or change their primary care physician and update their address.
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Referral Form Submission Instructions
PDF template
Comprehensive instructions for submitting medical referrals including patient demographics, service details, and pre-authorization requirements.
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Member Refund Request Form
PDF template
A form for members to request refunds for medical expenses through Prime Cure medical scheme.
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CHILDWARD RELEASE FORM
PDF template
A legal document granting Princeton University permission to record and use media of a child/ward for non-commercial purposes.
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Principal Consent Form For Student Judge
PDF template
A consent form for school principals to approve students serving as election judges for the Consolidated Election in Vermilion County.
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Medical History Form
PDF template
Comprehensive form for student medical background, enrollment status, and demographic information with tuberculosis screening and family health history sections.
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PRINTING WAIVER FORM
PDF template
A form used to request approval for using a printing vendor not on the pre-approved vendor list for procurement services.
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PrismRA Test Requisition Form
PDF template
A medical test requisition form for the PrismRA diagnostic test, collecting patient and provider information for genetic testing.
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Data Protection Consent Form For Consulting And Support
PDF template
A document outlining how Swiss Life processes personal data for consulting and support purposes, with details on privacy protection and data handling.
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Applifting Privacy Policy
PDF template
Privacy policy detailing personal data processing for website visitors and form users by Applifting s.r.o.
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Online Privacy Policy Agreement
PDF template
A comprehensive privacy policy detailing data collection, usage, and user rights for the Wimberley Lions Club website.
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Notice Of Privacy Practices
PDF template
A document outlining how medical information may be used, disclosed, and accessed while protecting patient privacy.
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Data Protection Consent Form Website Swisslife.Ch
PDF template
A comprehensive document outlining Swiss Life's data protection principles and consent mechanisms for website users and their personal data processing.
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Form Consent
PDF template
Instruction for collecting consent to process personal contact information for tax communication purposes
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Medical Form For The Priya Jewish Reproduction Fund TestingTreatment Summary
PDF template
Comprehensive medical form for documenting fertility testing, medical history, and treatment plans for reproductive healthcare.
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NTU VTH COVID 19 Safety Procedures For CanineFeline Appointments
PDF template
Detailed safety procedures for pet owners visiting the veterinary clinic during the COVID-19 pandemic, including communication, payment, and pet handling guidelines.
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PROCEDURALSURGICAL PROCTORPRECEPTOR EVALUATION FORM
PDF template
A comprehensive form for evaluating medical practitioner's procedural and surgical competence across multiple expertise domains.
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CASSCA VOLUNTEER REQUEST FORM
PDF template
A volunteer agreement form for students participating in a university activity, outlining responsibilities and liability waivers.
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Important Notices To The Applicant
PDF template
Legal notice outlining an applicant's duty of disclosure when applying for a general insurance contract, including potential consequences of non-disclosure.
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Professional Referral Form
PDF template
A professional form for healthcare providers to refer patients to the Center for TMJ and Sleep Disorders for medical evaluation.
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Professional Persons Feedback Form
PDF template
A form for submitting complaints or comments about healthcare professionals, organizations, or policies with detailed feedback collection.
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Shasta County HHSA Program Diagnosis And Discharge Form
PDF template
A form used by healthcare professionals to document patient diagnosis, medical conditions, and discharge details for mental health programs.
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Project Coordinator Agreement And Waiver Form
PDF template
A legal waiver and agreement form for participants coordinating community cleanup trailer usage in Marshall County, Indiana.
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Project ELEVATE Medical Form
PDF template
A comprehensive medical history and emergency contact form for individuals participating in Project ELEVATE at RCC.
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Disability Claim Form
PDF template
A comprehensive form for employees to file a disability claim, documenting medical condition, work status, and physician certification.
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Proof Of School Dental Examination Form
PDF template
Official form for documenting student dental health status and treatment needs for Illinois schools.
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Proof Of Health Insurance Form
PDF template
Form for students in the M.D. program to provide proof of health insurance coverage or enroll in the university's student health insurance plan.
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Proof Of Insurance Form
PDF template
Form for verifying medical and emergency insurance coverage for students, faculty, and staff traveling internationally.
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Hematopathology Requisition
PDF template
A comprehensive medical test request form for hematopathology testing with patient, physician, and insurance information.
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Property Owner Consent Form
PDF template
A form authorizing a legal representative to act on behalf of a property owner for various environmental health permit applications in Buncombe County, North Carolina.
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Property OwnerS Consent To Operate A Sidewalk Cafe Or Roadway Cafe
PDF template
A consent form for property owners to approve sidewalk or roadway cafe operations in front of their premises in New York City.
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FUSF Proposal Form General Awards Track
PDF template
A comprehensive proposal form for researchers seeking funding from the Focused Ultrasound Surgery Foundation's General Awards Track.
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Research Proposal Form
PDF template
A comprehensive research proposal template for scientific studies at Maroof International Hospital Research Department.
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Prosthetic Devices Referral Form
PDF template
A comprehensive form for collecting client information, referral details, and measurements for prosthetic device customization with integrated heating system.
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Patient Referral Form
PDF template
A referral form for dental patients seeking prosthodontic or general dentistry services at a dental practice or clinic.
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Temporary Information Authorization And Release
PDF template
A medical form for releasing medical information to the National Rifle Association's Competitive Shooting Sports Protest Committee
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Institutional Review Board (IRB) Protocol For Submitting An Application For Review
PDF template
Guidelines for submitting research applications involving human subjects at Rockland Community College, detailing required documentation and consent procedures.
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Provider Evaluation Form
PDF template
A confidential form used to assess a healthcare provider's professional qualifications, abilities, and potential issues for network participation.
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Provider Incident Report Form
PDF template
A form for documenting and reporting healthcare-related incidents, including details about harm, root cause, and prevention strategies.
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Provider Inquiry Form
PDF template
A confidential form for healthcare providers to submit claims, coordination of benefits, and related inquiries to Independent Health insurance.
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Provider Re Enrollment Form Following A Withdrawal
PDF template
A form for healthcare providers to assess and recommend a student's return to Binghamton University after a medical or psychological withdrawal.
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Inquiry Form
PDF template
A form for submitting inquiries related to medical services, enrollment, and claims payment for NJ FamilyCare program.
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AUTHORIZATION, RELEASE, WAIVER INDEMNITY AGREEMENT
PDF template
Legal document outlining participant risks, insurance, and liability terms for city recreational activities and facilities.
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Group Disability Insurance Disability Claim Instructions
PDF template
Comprehensive instructions for filing a disability insurance claim with Prudential, detailing required documentation and submission process.
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Public Schools Athletic League Interscholastic Athletics Parental Consent Form
PDF template
A consent form for parents/guardians allowing students to participate in school sports activities, acknowledging risks and responsibilities.
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Media Release
PDF template
Legal document granting permission to use personal media and content for publicity and educational purposes.
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RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
PDF template
Legal document waiving rights and releasing organizations from liability for participation in military community recreation activities.
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RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT PSP Recreation Programs
PDF template
Legal document waiving rights and releasing Canadian Forces Morale and Welfare Services from liability for recreational program participation
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Fellowship Application Form
PDF template
Application form for psychiatric fellowship programs at NYU Medical Center, covering personal information, education, and professional details.
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PSYCKES Consent Form
PDF template
A form allowing patients to consent or deny provider access to their Medicaid medical records through the PSYCKES electronic system.
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Electronic Data Interchange (EDI) Submission Enrollment Packet
PDF template
A comprehensive guide for electronic claims submission to Louisiana Medicaid, explaining Submitter ID and Provider ID processes.
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MEDICAL GENOMICS LABORATORY PTEN PHENOTYPIC CHECKLIST FORM
PDF template
A detailed medical form for documenting clinical and genetic information related to PTEN-associated syndromes like Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome.
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New Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal information, contact details, medical history, and health concerns.
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Postgraduate Training Program Enrollment Form
PDF template
Official form for enrolling and documenting postgraduate medical training for osteopathic medical residents in California.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form capturing patient's personal health information, previous conditions, treatments, and current health status.
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Department Of Psychiatry Fellowship Application Form
PDF template
Application form for psychiatry fellowship programs at NYU covering various subspecialties and requiring comprehensive candidate information.
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Virtual Programming Consent And Waiver Form
PDF template
A consent and waiver document for participants in Princeton University's virtual programming, covering participation terms, risks, and accommodations.
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PVCC Risk Assessment Form For Services
PDF template
A comprehensive risk assessment document for evaluating potential risks associated with outside vendors performing services on campus.
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Patient Intake Form
PDF template
Comprehensive medical intake form for collecting patient personal, contact, and health information at a medical practice.
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Bank Account Aadhaar Linkage Application Form
PDF template
Application form for linking an individual's Aadhaar number with their bank account to enable direct benefit transfers.
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Medical Service Authorization Request Form
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A form used to request medical service authorization for PrimeWest Health members, requiring detailed provider and patient information.
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PWD Shuttle Service Request Form
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Form for students with disabilities to request specialized shuttle transportation services at Montclair State University.
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Invoice Form V2.2
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Invoice form for billing medical simulation services with cost breakdown for internal and external participants.
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Tip Sheet Consent In Qualtrics
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A technical guide for creating and managing consent forms within the Qualtrics survey platform, including file insertion and print functionality.
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Endocrinologist Quarterly Evaluation Checklist
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Quarterly medical monitoring form for commercial motor vehicle drivers with diabetes seeking federal exemption from standard medical requirements.
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Prerequisite Verification Waiver Form
PDF template
A form for CT State students to request assistance with course prerequisite errors or course waiver requests for registration.
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Accident Waiver And Release Of Liability Form
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Legal document releasing Luvin Arms Animal Sanctuary from liability during volunteer activities and sanctuary visits.
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Artist Waiver Form For Alumni Art Exhibit
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Waiver form for artists submitting artwork to an alumni art exhibit, outlining submission requirements and liability terms.
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NL Template (Personal) Data
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A document for managing and documenting personal data collection and processing in clinical trials under EU Regulation 536/2014.
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Disability Form
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A comprehensive form for documenting an employee's disability status, medical details, and work-related information for insurance or employer records.
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Acknowledgement Of Risk Assessment Form
PDF template
A form for documenting understanding and acknowledgement of workplace risk assessments and associated hazard controls.
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Rabies Examination Form
PDF template
A comprehensive form for documenting and reporting details about an animal suspected of rabies exposure or infection.
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Rabies Test Requisition Form
PDF template
A form used to submit an animal specimen for rabies testing, documenting incident details, exposure information, and laboratory testing parameters.
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OSDHOADDL Rabies Specimen Submission Form
PDF template
Official form for submitting animal specimens to the Oklahoma Animal Disease Diagnostic Laboratory for rabies testing and documentation.
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Test Requisition Form Animal Rabies
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A form for submitting animal brain tissue samples for rabies virus testing by the Ventura County Public Health Laboratory.
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5K Race Waiver For Runners, Walkers And Mixed Teams
PDF template
Legal waiver for participants in a 5K run/walk event, releasing organizers from liability and acknowledging physical risks.
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PATIENT INTAKE FORM
PDF template
A comprehensive patient intake form collecting personal, contact, insurance, and medical authorization details for healthcare services.
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Patient Intake Questionnaire Speech (Pediatric)
PDF template
Comprehensive medical and developmental questionnaire for children with potential speech and language concerns.
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Radiograph Set Submission Form
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A certification form for submitting radiograph sets by residents with supervisor approval in veterinary dentistry.
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RISK ASSESSMENT FORM EMERGENCY RESPONSE 2.0
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A comprehensive form for evaluating building risk factors for emergency response planning, including construction type, occupancy, and fire safety characteristics.
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Randall ChildrenS HospitalSpecialty Referral
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A comprehensive medical referral form for various pediatric specialty services at Randall Children's Hospital across Oregon and Washington locations.
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Student Drug Testing Consent Form For Minor Student
PDF template
Consent form for drug testing of students participating in school-sponsored extracurricular activities
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Referral Form
PDF template
A comprehensive referral form for collecting detailed information about a child, their medical history, and family background for support services.
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Youth Release Form
PDF template
Release form for youth participation in Mid-America Regional Assembly event, including medical authorization and parental consent.
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RBC Proposal Form
PDF template
A proposal form for submitting changes to risk-based capital methodology and documentation for insurance regulators.
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RBC Proposal Form
PDF template
Proposal form for submitting changes to Risk-Based Capital (RBC) regulations and instructions across different insurance sectors.
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PhotoMedia Release Form
PDF template
A consent form allowing RurAL CAP to use photographs, video, audio, and textual materials for publication purposes.
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PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history document for collecting patient health information, medical conditions, and social history details.
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Health Intake Form
PDF template
Comprehensive medical history and health assessment form for new patients of the Riordan Clinic.
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Readmission Review Form
PDF template
A comprehensive form for reviewing patient hospital readmissions, tracking reasons for return, and assessing discharge follow-up procedures.
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Release Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document releasing liability for participation in an event, assuming risks, and indemnifying the event organizers.
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Reasonable Accommodation Medical Authorization Form
PDF template
A form for employees to request workplace accommodations by providing medical documentation about a disability or medical condition.
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Application To Request A Reasonable Accommodation Of A Disability
PDF template
A formal application for employees to request workplace accommodations for disabilities, requiring details from both the employee and their medical professional.
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Application For Out Of State Tuition Differential Waiver For Recently Separated Military Personnel
PDF template
Application for military service members and their families to receive in-state tuition rates at Valdosta State University within 12 months of military separation.
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Donated Leave Program Recipient Affidavit Form
PDF template
A form for employees to request donated leave time from colleagues during a serious health condition or injury.
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Application For Waiver Of 3 Day Marriage License Waiting Period
PDF template
Legal document allowing couples to request exemption from the standard 3-day waiting period for obtaining a marriage license in Iowa.
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Pre Health Committee Letter Of Recommendation Waiver Form
PDF template
A form for students to provide consent and waive rights for obtaining a letter of recommendation for professional school applications.
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Records Release Consent Form
PDF template
Form for students to request release of academic records to designated recipients via email or standard mail.
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Volunteer Registration Form
PDF template
Registration form for volunteers with Carroll County Department of Recreation & Parks, including liability waiver and background check requirements.
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Recreation Insurance Form
PDF template
Insurance form for participants in the Hammonton Recreation Program, covering medical liability and insurance information.
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Recommendation For A Reduced Course Load Due To An Illness Or Medical Condition
PDF template
A form allowing students to request reduced course load or withdrawal due to medical conditions, with medical provider documentation.
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Reference Checking Consent And Authorization Form
PDF template
A consent form allowing Texas Southern University to conduct reference checks and contact previous employers during the hiring process.
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SCAN Referral Authorization Request Form
PDF template
A medical service referral and authorization form for SCAN Health Plan to request prior approval for medical services or procedures
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LCR.FORM.11 Referring Veterinarian Information Form
PDF template
Form for submitting animal laboratory samples and patient information to Virginia Tech Animal Laboratory Services.
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COMMONWEALTH DERMATOLOGY REFERRAL REQUEST FORM
PDF template
A medical referral form for patients seeking dermatological services, to be completed by a healthcare professional.
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Referral Form
PDF template
A comprehensive form for referring children for developmental health evaluation and potential intervention services.
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Aetna Better Health Of Florida Referral Form
PDF template
A referral form for healthcare providers to refer patients to specialists or diagnostic services within the Aetna Better Health of Florida network.
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REFERRAL FORM
PDF template
Medical referral form for home health services detailing patient information, medical needs, and service requirements.
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Referral Form
PDF template
A form used by healthcare providers to refer a patient to another medical professional or service for specialized care or consultation.
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Department Of Human Genetics Referral Form
PDF template
Comprehensive referral form for genetic consultation and screening, listing various genetic conditions and required documentation for scheduling.
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Family Resource Center Referral Form
PDF template
A referral form for accessing family support services, including consent for information release and service authorization.
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COMMUNITYCARE REFERRALAUTHORIZATION FORM
PDF template
A medical referral and authorization form for Medicaid patients seeking healthcare services through the CommunityCARE program
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Referral Form CT Endoscopy
PDF template
A comprehensive referral form for veterinary diagnostic procedures including CT scan, endoscopy, and internal medicine consultation.
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Medical Respite Referral Request Form
PDF template
A comprehensive referral form for medical respite services, used to evaluate patient eligibility for admission to a medical respite program.
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Client Referral Form
PDF template
A comprehensive form for collecting client personal, contact, insurance, and referral information for healthcare or social services.
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Patient Referral Form
PDF template
A comprehensive patient referral form for medical consultations and appointments related to ear, nose, and throat medical services.
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Patient Referral Form
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A medical referral form for functional vision evaluation with multiple diagnostic and symptom checkboxes for vision-related concerns.
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Medical Form For Neuropsychological Assessment
PDF template
A comprehensive medical form for requesting neuropsychological assessments, including patient information, referral reasons, and assessment details.
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Walker Memory Center Referral Form
PDF template
Medical referral form for memory evaluation and neuropsychological testing at Walker Memory Center.
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Referral Form Internal Medicine
PDF template
A comprehensive referral form for veterinary internal medicine consultations, capturing patient details, medical history, and diagnostic information.
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Referral Form
PDF template
A comprehensive patient referral form for healthcare services with sections for patient information, insurance details, referral source, and service needs.
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Referral Form
PDF template
Medical referral form for transferring patient information between healthcare providers for specialty consultation or treatment.
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Sutter Specialty Services Referral Form
PDF template
A referral form for patients seeking specialty medical services through Sutter Health network with detailed patient, physician, and insurance information.
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EDRC 253 REFERRAL FORM
PDF template
Comprehensive medical referral form used to collect patient demographics, insurance information, and clinical details for healthcare services.
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Physician Referral Form
PDF template
A form for healthcare providers to refer patients to other medical departments or providers with patient and referral contact details.
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REFUSE Insurance Form INTERNATIONAL
PDF template
Form for international students to waive mandatory student insurance by providing alternative coverage documentation.
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REFUSE Insurance Form (Montana Medicaid)
PDF template
A form for students to waive student health insurance coverage and acknowledge non-coverage by Montana Medicaid at the Curry Health Center.
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REFUSE Insurance Form (U.S. Citizens)
PDF template
A form for students to declare existing private health insurance coverage and waive university-provided insurance requirements.
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Regence BlueShield Incident Report
PDF template
A form for reporting medical incidents or injuries that may affect insurance claims processing for Regence BlueShield in Washington State.
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Member Reimbursement Form
PDF template
A comprehensive form for members to submit healthcare service reimbursement claims, including details about patient, services, and coverage.
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Registration Form
PDF template
A comprehensive registration form for participating in park district programs with program selection and liability waiver.
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ATHLETE WAIVER MEDIA RELEASE FORM
PDF template
Comprehensive form for athlete registration, medical information, emergency contacts, and liability waiver for cheerleading activities.
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REGISTRATION APPEAL MEDICAL VERIFICATION OR MEDICAL CARETAKER VERIFICATION FORM
PDF template
A form for students to request course withdrawal or GPA adjustment due to medical circumstances, requiring medical provider verification.
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REGISTRATION FORM
PDF template
A comprehensive registration form for recreational activities that collects participant and emergency contact information, including liability waivers and medical consent.
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LSA LSC Adult Soccer Medical Release Form And Waiver Hold Harmless Agreement
PDF template
Medical release form and liability waiver for adult soccer players detailing personal and emergency contact information and medical consent.
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LSA LSC Youth Soccer Medical Release Form And Waiver Hold Harmless Agreement
PDF template
Medical release and consent form for youth soccer players, including emergency contact and medical information
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Youth Medical Release Form And Waiver Hold Harmless Agreement
PDF template
A medical release and waiver form for youth soccer players, documenting medical information and parental consent for participation.
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Anchorage Parks Recreation Program Registration Form
PDF template
A comprehensive registration form for participating in Anchorage Parks and Recreation programs, including participant details, waiver, and payment information.
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Insurance Referral And Financial Responsibility Form
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A document outlining patient insurance participation, referral requirements, and financial responsibilities for medical services at Eye Associates of Utica.
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ECHN REHABILITATION SERVICES MEDICAL HISTORY
PDF template
A comprehensive form for collecting patient medical history, current health conditions, and relevant health information for rehabilitation services.
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Hopelink Reimbursement Form
PDF template
Guidelines for requesting reimbursement for parking, bridge tolls, and ferry expenses related to medical appointments.
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Release And Indemnification Agreement For Minors
PDF template
A legal document granting parental permission for minor's participation in Bay View activities and waiving liability for potential injuries or damages.
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Release And Indemnification Agreement For Minors
PDF template
A legal document granting parental permission for minor participation in Bay View activities and waiving liability for potential injuries or damages.
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RELEASE AND INDEMNIFICATION AGREEMENT FORM UTRGV CELLO FESTIVAL
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A legal document releasing the institution from liability for potential injuries or damages during participation in the Cello Festival event.
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Salk Institute Volunteer Waiver
PDF template
Legal document waiving liability for volunteers participating in Salk Science and Music Series event, assuming all risks of participation.
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Participant Liability Release And Waiver Form
PDF template
A comprehensive liability release form for participants in cheer and dance events, covering personal and minor participant involvement.
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MEDIA RELEASE FORM
PDF template
Form granting permission for Pacific University to use personal image and audio/video recordings for promotional purposes.
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Media Release Form
PDF template
A legal document granting permission for Professional Interpreting Enterprise to use an individual's image and likeness for advertising purposes.
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Media Release Form
PDF template
A document granting Pacific University permission to use an individual's photographic or recorded media for promotional purposes.
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Volunteer Signup
PDF template
A legal document outlining liability release and waiver for volunteers participating in Next Step STORM activities.
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MEDIA RELEASE FORM
PDF template
A form granting permission for a school or parish to use an individual's image, likeness, or voice in various media productions and news coverage.
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Agreement And Release Of Liability Form
PDF template
A legal document that releases Ohio University from liability for potential injuries during a university-sponsored program or camp.
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Media Release Form
PDF template
A legal document granting permission for the University of New Mexico to use an individual's photographs, recordings, and likeness for promotional or educational purposes.
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North Shore Winter Club Release Agreement
PDF template
Legal document waiving claims and assuming risks for participation in club activities, specifically hockey-related events.
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North Shore Winter Club Release Agreement
PDF template
Legal document waiving rights to sue or claim compensation for potential injuries or damages during club activities.
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Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving rights and assuming risks for participation in gymnastics activities with Gymnastics BC.
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Off Campus Event Policy Form 2
PDF template
A legal document releasing California State University, Fresno from liability for potential risks during off-campus academic events.
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Release Of Liability And Accident Waiver Form
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Legal document releasing liability for participants in log construction training activities, covering potential risks and injuries.
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RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS
PDF template
Legal document releasing California State University, Fullerton from liability for potential injuries or damages during an activity or related travel.
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HCC Risk Management Student Waiver Form
PDF template
A comprehensive liability waiver and release form for students participating in domestic travel programs through Houston Community College.
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DOHEO Medical Release Form For ADA Purposes
PDF template
A medical authorization form allowing disclosure of medical information to determine disability accommodations under the Americans with Disabilities Act (ADA).
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Contract Of Release And Waiver Of Liability
PDF template
A legal document releasing liability for participants in military-style training activities with acknowledgment of inherent risks.
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Law Enforcement Employment Release And Waiver
PDF template
A legal document authorizing background investigation and information release for law enforcement employment application with the City of Los Angeles.
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RELEASE AND WAIVER FORM
PDF template
A legal document authorizing criminal record release for common carrier certification in Rhode Island and waiving related legal liabilities.
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Consent Form
PDF template
A consent form for participants or parents/guardians to authorize entry into the USCCB Religious Liberty Essay Contest for individuals under and over 18 years old.
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Remote Hearing Agreement Form
PDF template
A form for claimants to consent to telephone or online video hearings for Social Security Administration proceedings.
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Removal Of Direct Deposit FormEFT Waiver Request
PDF template
Form for requesting removal of electronic funds transfer and switching to paper treasury checks for federal payments.
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Rental Inspection Consent Form
PDF template
A legal consent form allowing city inspectors to conduct mandatory rental property inspections in compliance with Boston city ordinances.
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Repair Exchange Risk Assessment Form
PDF template
A form for identifying and mitigating potential hazards during a repair and exchange event.
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Waiver Report PUBLISH
PDF template
Report seeking approval to waive contract procedure rules for maintenance and upgrade of library RFID self-service equipment.
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Report A Hazard
PDF template
A guide for reporting hazards and creating action plans to eliminate or reduce workplace risks using the Riskware Incident and Hazard module.
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Family And Medical Leave Request Form
PDF template
A form for employees to request family or medical leave, detailing reasons for absence and relevant employee information.
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REQUEST FOR REGULATION WAIVER FORM
PDF template
A form for requesting a waiver from specific regulatory requirements in New York state for healthcare or housing facilities.
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Aflac Benefit Services Request For Reimbursement Form
PDF template
A form for requesting reimbursement from a Flexible Spending Account (FSA) for medical care expenses.
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CONSENT TO THE SALE OR TRANSFER OF PROPERTY REQUEST FORM
PDF template
A form used by property owners to request HPD's consent for sale or transfer of property subject to HPD restrictions.
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Request For Waiver Of Competitive Bidding
PDF template
A form to request exemption from competitive bidding requirements for university purchasing at Ohio State University.
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MEDICAID HOSPICE DISCHARGE FORM
PDF template
Official form documenting the discharge of a patient from a Medicaid hospice program, including reasons for termination of services.
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Medical Release Form
PDF template
A comprehensive medical release and emergency contact form for students participating in College of DuPage's Youth Academy program.
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Anatomic Pathology Requisition Form
PDF template
Medical requisition form for submitting biopsy and pathology specimens with patient and provider information for diagnostic testing.
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COVID 19 RNA AND ANTIBODY DETECTION REQUISITION FORM
PDF template
Medical form for collecting patient information and requesting COVID-19 RNA and antibody testing
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REQUISITION FORM FOR LICEADVISOR
PDF template
A requisition form for sea lice analysis with options for testing sensitivity to various therapeutic agents for fish breeding.
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Ultrasound AndOr Mammography Requisition
PDF template
Instructions and patient preparation guidelines for various ultrasound and mammography examinations with patient information section.
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RequisitionPre Authorization Form
PDF template
A form for requesting additional medical testing at Regional Medical Laboratory, including patient and insurance information verification.
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UC HIPAA Research Authorization 2014
PDF template
A form granting permission to use personal health information for research purposes under HIPAA regulations.
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Authorization Form For The Use And Disclosure Of Patient Health Information For Research Purposes
PDF template
A form that provides consent for the use and disclosure of patient health information in a research study at the University of WisconsinMilwaukee.
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Investigator Initiated Research Grant Application Form
PDF template
A comprehensive form for researchers seeking funding and approval for investigative research projects from Paragon28.
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RESEARCH INQUIRY WALSH LAB
PDF template
A research inquiry form for collecting patient information and medical history for potential participation in a Walsh Lab study.
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Mansfield Independent School District Research Review Instructions
PDF template
Guidelines for submitting research proposals to Mansfield Independent School District, including required documentation and procedures.
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Research Volunteer Application
PDF template
Application form for potential research volunteers at the University of Texas Health Science Center San Antonio's Department of Anesthesiology Division of Research.
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Child Assent Parent Consent Instructions Samples
PDF template
Comprehensive guide for obtaining parental consent and child assent for research involving participants under 18 years old.
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IRB Guidance For Researchers
PDF template
Comprehensive guidelines for conducting research involving minor participants, outlining required protections, consent procedures, and ethical considerations.
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Vantage Learning International Channels Program
PDF template
A strategic program by Vantage Learning to expand international channels and partner with organizations for educational technology services.
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Locker Items ReleaseWaiver Form
PDF template
Form for students to acknowledge locker rental terms and responsibility for removing personal items by specified dates.
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Residency In Small Animal Emergency And Critical Care
PDF template
A three-year post-DVM training program in veterinary emergency and critical care medicine designed to prepare residents for board certification.
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Residency Requirement Waiver Form
PDF template
Form allowing students to request exemption from mandatory on-campus housing based on specific qualifying criteria
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Fontbonne University Resident Medical Information
PDF template
Comprehensive medical information and immunization requirements for first-time resident students at Fontbonne University.
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RADIOLOGY LEAVE REQUEST FORM
PDF template
A comprehensive form for radiology residents to request various types of leave with multiple approval levels.
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Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for pathology residents seeking specialized fellowship training in various pathology subspecialties.
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Medical Society Of New Jersey Resolution Submission Form
PDF template
A form for medical society members to submit proposed resolutions on healthcare policy and related topics.
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MEDICAL DENTAL APPOINTMENT FORM
PDF template
A comprehensive form for documenting a child's medical or dental appointment details including patient information, appointment specifics, and medical recommendations.
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OSHA Medical Evaluation Form
PDF template
A confidential medical questionnaire for employees required to use respirator masks, assessing their medical readiness for mask fitting.
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Hospital Discharge Intake Form
PDF template
A form for evaluating patient eligibility for short-term respite care after hospital discharge, including medical stability and independence requirements.
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Photograph Inventory Form
PDF template
Form for submitting retaken photographs to a Reading Center with patient and photographic details.
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RETIREE ACH AUTHORIZATION FORM
PDF template
A form authorizing HealthTrust to process monthly medical and dental contribution payments via automated bank transfer.
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Reimbursement Form
PDF template
A form for requesting reimbursement for medical care, supplies, and healthcare expenses from an insurance provider.
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Retirement Plan And Disability Waiver Form
PDF template
Form for waiving waiting period for retirement and disability coverage when transferring employment to Northeastern
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Reviewer Checklist (Form IRB5)
PDF template
A comprehensive checklist for Institutional Review Board (IRB) reviewers to evaluate research protocol applications for ethical and methodological soundness.
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Reviewer Consent Checklist (Form IRB6)
PDF template
A comprehensive checklist for reviewing and validating consent forms for research studies, ensuring all critical elements are properly documented.
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Post Accident AlcoholDrug Test Consent Form
PDF template
Consent form for employees to authorize alcohol and drug testing following a workplace accident or incident, with potential employment consequences.
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COMMON WELL ENROLLMENT CONSENT FORM
PDF template
A consent form for patients to authorize sharing of medical information through the CommonWell health information network for continuity of care.
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Revised ProceduralSurgical Consent Form Frequently Asked Questions
PDF template
Document explaining revisions to a medical consent form and addressing frequently asked questions about signature and content changes.
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Participation Agreement And Waiver Form
PDF template
A legal document for parents/guardians to authorize and acknowledge risks for a child's participation in a University of Michigan program or camp.
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Patient Medical History Form
PDF template
Comprehensive medical history document capturing patient's medications, allergies, past medical conditions, surgical history, family health history, and lifestyle details.
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Diving Medical Exam Overview For The Examining Physician
PDF template
Medical examination document assessing fitness for scientific diving certification at the University of New Hampshire.
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Physical Activity Participation Waiver
PDF template
A liability waiver and consent form for participants in an online physical activity program, addressing risks and electronic communication consent.
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RFFIT Submission Form For Animals
PDF template
A form for submitting animal specimens for rabies antibody titer testing at the Kansas State Veterinary Diagnostic Laboratory.
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RFFIT Submission Form For Animals
PDF template
Form for submitting animal specimens for rabies antibody titer testing to determine vaccine response
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Federal Financial Assistance (FFA) Waiver Submission Form
PDF template
Form for federal agencies to request waivers for using goods or materials manufactured outside the United States under specific conditions.
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VantageCare RHS Plan Claim Form
PDF template
Form for submitting medical expense reimbursement claims to the VantageCare RHS Plan administered by Meritain Health.
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Volunteer Agreement Form
PDF template
Legal document outlining volunteer responsibilities and liability waivers for Rimrock Humane Society volunteers.
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Service Request Form
PDF template
A form for requesting research services from the Radioimmunoassay and Biomarker Core at The Smilow Center for Translational Research.
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RIDOH State Health Laboratories Test Requisition
PDF template
A comprehensive medical test requisition form for submitting patient specimens to Rhode Island State Health Laboratories for various diagnostic tests.
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Outpatient Physician Visit Referral Form
PDF template
A medical referral form used to schedule patient appointments and transfer clinical information between healthcare providers.
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Incident Report
PDF template
A comprehensive form for documenting and reporting critical incidents involving service recipients, detailing medical, legal, and social aspects of the event.
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RINGETTE BC MEDICAL FORM
PDF template
A confidential medical form for Ringette BC athletes to collect personal health and emergency contact information.
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Liability Waiver And Release Form (Minor Child)
PDF template
A legal document releasing Harvard University from liability for potential injuries or damages during ice skating activities for a minor child.
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DANCEDANCEPOMS TEAM RISK ACKNOWLEDGEMENT
PDF template
A comprehensive risk acknowledgement and responsibility document for high school dance and poms team athletes and their parents/guardians.
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Risk Acknowledgement And Emergency Contact Form
PDF template
A university form documenting participant risk acknowledgement, emergency contact information, and medical authorization for university-sponsored programs.
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Risk Assessment Form
PDF template
A form to assess vendor compliance and safety procedures for a popup restaurant at Northwestern University in Qatar.
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MBCC Risk Assessment Review Form
PDF template
A comprehensive form for evaluating risk factors and compliance of sub-grantee agencies receiving grants.
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Risk Assessment Form
PDF template
Comprehensive form for identifying, evaluating, and managing potential risks across organizational environments and activities.
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Texas AM University San Antonio Risk Assessment Matrix
PDF template
A comprehensive risk assessment tool for evaluating potential hazards and risks associated with university events and activities.
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SubRA V2.2.Xlsx
PDF template
A comprehensive risk assessment form for subrecipients evaluating their experience, monitoring, operations, and financial capabilities for federal funding.
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RISK ASSESSMENT FORM
PDF template
A comprehensive form for student organizations to evaluate and manage potential risks associated with planned events or activities.
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Risk Assessment Summary Report Form
PDF template
A comprehensive document for systematically evaluating and documenting organizational risks, findings, and recommendations across different time horizons.
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STUDENT SUICIDE RISK ASSESSMENT FORM
PDF template
A comprehensive form to evaluate a student's suicide risk by assessing current mental state, ideation, plans, and intent.
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Unconditional And Full General Release And Covenant Not To Sue
PDF template
A legal release form for participants of a university-sponsored trip, waiving liability and acknowledging risks.
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Accident Claim Form
PDF template
A claim form for submitting accident-related insurance claims with specific filing instructions and requirements.
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Sample Parent Guardian Consent And Emergency Contact Form
PDF template
A consent form for parents or guardians to authorize children's participation in a program and provide emergency contact information.
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State Of Iowa Criminal History Record Check Request Form
PDF template
Official form for requesting a criminal history record check from the Iowa Division of Criminal Investigation (DCI)
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CLIENT BILL REQUISITION FORM
PDF template
A medical form for ordering laboratory tests with patient and practitioner information collection fields.
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Insurance Bill Requisition Form
PDF template
A medical laboratory test request form for collecting patient information, test orders, and billing details.
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Insurance Bill Requisition Form
PDF template
A comprehensive form for collecting patient and practitioner information for medical laboratory testing and insurance billing purposes.
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Activity Liability Waiver And Release Agreement
PDF template
Legal document for students to acknowledge risks and release liability for participating in college-sponsored activities or events.
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RMBEST Background Check Consent Form
PDF template
Consent form for volunteers with Rocky Mountain BEST to undergo a criminal background check for interaction with students.
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Medical Expense Reimbursement Form
PDF template
Step-by-step guide for submitting a medical expense reimbursement claim using a PDF form on the Benserco website.
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Iowa 4 H Medical InformationRelease Form
PDF template
A comprehensive medical information and emergency contact form for non-4-H club youth participants.
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RoboCamp RIT Medical And Health Insurance Form
PDF template
Comprehensive medical history and health information form for students attending RoboCamp at RIT
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Rock Wall Waiver Form
PDF template
Liability waiver and rules of conduct for participants using the rock climbing wall at Hulsey Wellness Center.
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Sample Consent To Release Or Obtain Information Form
PDF template
A legal form allowing tenants to provide consent for releasing or obtaining personal information for housing or social services applications.
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North Carolina High School Athletic Association Sport Preparticipation Examination Form
PDF template
A medical screening form for student-athletes to assess their health and fitness for sports participation.
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ROMEO Research Proposal Form
PDF template
A comprehensive form for submitting research proposals to ROMEO Ophthalmology, detailing project specifics, contributors, and data management plans.
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RISK ASSESSMENT FORM
PDF template
Comprehensive risk assessment for visitor areas focusing on potential trips, falls, and safety measures in a roof garden environment
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Rothesay HIVE Membership Form
PDF template
Annual membership form for the Rothesay HIVE community center with contact and waiver information.
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Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving liability for participants in a county shuttle bus event, acknowledging potential risks and releasing the organization from claims.
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Hospice Referral Form
PDF template
A comprehensive form for initiating hospice care referral, collecting patient medical, personal, and insurance information.
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NEW PATIENT REGISTRATION FORM
PDF template
Comprehensive medical intake form for new patients, including personal information, insurance details, and arbitration agreement.
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ATSDR Rapid Response Registry Survey Form
PDF template
A survey form for collecting health information from individuals exposed to an emergency event, with consent and confidentiality provisions.
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EMPLOYEE MEDICAL RELEASE FORM
PDF template
A form authorizing an employer to obtain and review medical information related to an employee's ability to perform job tasks safely.
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Individual Travel RegistrationWaiver Form
PDF template
A comprehensive form for student travel registration, liability waiver, and emergency contact information for university-sponsored trips.
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Participant And Volunteer Accident Waiver And Release Of Liability
PDF template
A legal document releasing liability for participants and volunteers in a bicycle riding event, outlining risks and assumption of responsibility.
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Patient Enrollment Form
PDF template
Enrollment form for patients seeking treatment with RUCONEST for hereditary angioedema (HAE)
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Rule 115A Limited Representation
PDF template
Legal rules governing how attorneys can provide limited scope representation to clients with specific consent and procedural requirements.
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Financial Assistance Application Form
PDF template
Comprehensive form for patients to apply for financial assistance, collecting detailed personal, employment, and income information.
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Accident Waiver And Release Of Liability Form
PDF template
Legal document releasing liability for participants in a 5K run/walk event organized by the Wisconsin Section of the American Water Works Association.
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Allergy Reimbursement Claim Form
PDF template
A form for submitting claims for allergy treatments and medications for reimbursement by an insurance provider.
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Preparticipation Physical Evaluation Physical Examination Form
PDF template
Comprehensive medical screening form for athletes to assess physical fitness and health status prior to participation in sports activities.
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BW RYSTIGGO V.I23
PDF template
Medical referral and patient information form for Rystiggo (rozanolixizumab-noli) treatment for Generalized Myasthenia Gravis
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Accidental Injury Claim Form
PDF template
Insurance claim form for reporting and processing an accidental injury claim with Aflac
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Initial Disability Checklist
PDF template
A comprehensive form for filing a disability insurance claim, collecting details about the nature of disability, patient, and policyholder information.
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Continuing Disability Claim Form
PDF template
A claim form for filing a continuing disability insurance claim with Aflac, requiring policyholder and patient information.
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Schedule 4 Loan Consent Form
PDF template
A form documenting consent and details for a loan to a campaign finance entity by a lender.
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Sample Media Release Form
PDF template
Form allowing parents/guardians to grant or deny permission for children's photos to be used in church publications and media.
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Risk Form For The Revitalizing Main Streets Opportunity 1 Grant Initiative
PDF template
A comprehensive risk assessment form for local agencies applying for the Revitalizing Main Streets Opportunity 1 Grant Initiative, covering project and environmental details.
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Cadet Initial Entry Training (CIET) Medical Operations Pre Participation Physical Form Medical Hi
PDF template
Comprehensive medical history form for cadets participating in initial entry training, capturing health conditions, injuries, and personal medical information.
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Form14 SAFETY INSPECTION FORM
PDF template
Comprehensive safety inspection form for assessing workplace environments, covering areas like floors, stairs, equipment, storage, and fire safety.
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SAFETY MEETING REPORT FORM
PDF template
A form for documenting safety meetings for high-risk jobs, including meeting details, preparation, and employee comments.
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Voluntarily Hazard Report Form
PDF template
A form for reporting various types of workplace and public safety hazards voluntarily.
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SAFETY TALK HAZARD REPORTING
PDF template
Guidelines for identifying and reporting potential safety hazards in the workplace by employees.
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Informed Consent For Immunization With COVID 19 Vaccine
PDF template
A medical consent form for receiving COVID-19 vaccination, including patient personal and medical information.
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Sail Caribbean Medical Form
PDF template
A comprehensive medical form required for students participating in Sail Caribbean adventures, collecting health history and emergency contact information.
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Student International Experience Petition Form
PDF template
Form for faculty and students to propose and document international academic experiences at Northeast Ohio Medical University.
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SALES ORDER FORM
PDF template
A form for ordering surgical implants and equipment with detailed item tracking and customer information.
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Liability Waiver Form
PDF template
A legal document that releases Polk County Public Libraries and related parties from liability for participation in an activity and grants photo usage rights.
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Same Day Delivery Form
PDF template
Form allowing patients to receive medical devices on the day of evaluation, with information about potential insurance authorization and financial responsibilities.
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Obtaining Informed Assent From Children Or Minors
PDF template
Guidelines and sample forms for obtaining informed consent and assent from children or minors participating in research projects.
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SAMPLE ASSUMPTION OF RISK RELEASE
PDF template
A legal document that releases event sponsors from liability and acknowledges participant's voluntary assumption of risks during an event.
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Sample Informed Consent Form
PDF template
An informed consent document for a research study examining adults' attitudes toward legal testimony, involving survey participation and trial transcript review.
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Informed Consent Form Student Writing Analysis
PDF template
Consent form for a research study examining the impact of writing environment on student writing quality at Oklahoma City Community College.
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Consent To Participate In A Research Study
PDF template
Consent form template for adult participants in a social behavioral research study at the University of North Carolina at Pembroke.
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Sample Consent Form
PDF template
A template for obtaining informed consent from research study participants, outlining study details, risks, benefits, and participant rights.
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Consent To TattooPierce
PDF template
A legal consent form detailing risks, requirements, and patient acknowledgment for tattoo and piercing procedures in Montana.
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Sample Consent And Release Student To Be FilmedPhotographed For Use Of ImageVoice
PDF template
A consent form allowing a school district to record and use a student's image, voice, artwork, or written work for educational or promotional purposes.
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Sample Discharge Form
PDF template
A comprehensive discharge form for shelter guests documenting medical conditions, transportation needs, and post-evacuation services
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Sample Emergency Action Plan
PDF template
A comprehensive emergency preparedness document detailing contact information, emergency procedures, and roles for managing potential incidents.
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Sample Enrichment Initiative Approval Form
PDF template
A form for zookeepers to propose and get approval for animal enrichment initiatives and activities.
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Sample 1 Incident Investigation Form
PDF template
A comprehensive form for documenting and investigating workplace incidents or near misses to determine causes and recommend preventive actions.
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Informed Consent Form Template
PDF template
A template and guidelines for creating an informed consent document for research studies, outlining key sections and requirements.
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Sample Informed Parental Consent Form
PDF template
A consent form for parents to allow their child to participate in a research study examining children's conflict resolution reactions to a videotaped story scenario.
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Medical Release Form
PDF template
A medical clearance document for patients seeking to start a personalized fitness training program, requiring physician review and approval of exercise activities.
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Parental Consent Form For Participation In The Research Study
PDF template
A template consent form for parents to authorize their child's participation in a research study at Salem State University.
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Parental Consent Form
PDF template
A legal document granting consent for a minor to volunteer with TreePeople, including liability release and media usage permissions.
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PARENTLEGAL GUARDIAN CONSENT FORM
PDF template
Official consent form for a parent or legal guardian to authorize medical marijuana use for a non-emancipated minor patient in Missouri.
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Sample Passive Consent Form
PDF template
A consent form for parents/guardians to allow their child's participation in a school program and optional evaluation survey.
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You Matter Referral Form
PDF template
A referral and consent form for the Tlingit and Haida Indian Tribes of Alaska Tribal Child Support Unit to address support services for noncustodial parents.
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Referral Form (Sample Format)
PDF template
A standardized form for documenting patient referrals between healthcare service providers with client authorization.
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Release Consent Form
PDF template
A form granting permission for an organization to use photographs, audio, and visual recordings for nonprofit/educational purposes.
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Rental Agreement, Release And Assumption Of Risks
PDF template
A comprehensive rental agreement that includes risk assumption, liability release, and insurance acknowledgment for renting an interactive inflatable unit.
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Sample Submission Form
PDF template
A comprehensive form for submitting milk samples for various diagnostic tests for bovine species.
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SAMPLE SUBMISSION FORM WALSH LAB
PDF template
A medical research form for collecting family genetic sample information and consent for genetic studies.
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Sampling Requirement Or Treatment Technique Waiver Request Form
PDF template
Form for requesting a waiver for sampling requirements or treatment techniques for public water supplies in Dutchess County, New York.
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Irvine Unified School District Drive Up COVID 19 PCR Testing Authorization Form
PDF template
Authorization form for Irvine Unified School District employees to receive COVID-19 PCR testing at Sand Canyon Urgent Care Medical Center.
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ParentalGuardian Consent Form For The SAT Suite Of Assessments
PDF template
Consent form for students to participate in SAT Suite of Assessments during school day, including SAT, PSAT/NMSQT, PSAT 10, and PSAT 8/9.
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SB 1383 Organics Recycling Regulations Waiver Request Form
PDF template
A form for California properties to request exemption from mandatory organic waste recycling regulations under Senate Bill 1383.
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Parental Consent Form To Receive Health Care Services
PDF template
A comprehensive form for parents to provide consent and medical information for student health care services at school-based clinics.
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Society Of Biology Risk Assessment Form
PDF template
A comprehensive risk assessment document outlining health and safety evaluation procedures for events and activities.
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Patient Assessment Form (New Patients Only)
PDF template
Comprehensive medical intake form for new patients at Stony Brook Surgical Associates, collecting patient demographic and health information.
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REPORT OF ACCIDENT
PDF template
A comprehensive form documenting details of an accident, including personal information, injury specifics, and medical treatment
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SCA CM201 Financial Affidavit And Application
PDF template
A court form for individuals seeking to waive court fees, costs, or security in civil or domestic cases based on financial eligibility.
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Scaffold Inspection Form
PDF template
A comprehensive safety checklist for inspecting scaffold setup, stability, and compliance with workplace safety regulations.
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HOSPICE ORDER FORM
PDF template
A medical form for referring a patient to hospice care services, including patient information, orders, and physician details.
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UVA Biorepository Tissue Research Facility (BTRF) Scanning Service Request Form
PDF template
A form for researchers to request slide scanning services at the University of Virginia's Biorepository & Tissue Research Facility.
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DCOM Student Scholarly Activity And Research Project Form OMS I II
PDF template
A form for medical students to document and obtain approval for scholarly research activities with mentor and institutional review board guidance.
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H.E.L.P. The Lawrence J. Dippold Health Education Loan Program
PDF template
Scholarship program providing financial assistance for health-related career training at Guthrie Cortland Medical Center
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Media Release Form
PDF template
Media release form for scholarship applicants to authorize photo and image usage by Atlanta Alumnae Chapter
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Scholarship Application For Individuals Pursuing A Career In The Healthcare Field
PDF template
A scholarship application for students pursuing careers in healthcare, sponsored by Lawrence General Hospital Medical Staff.
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Scholarship Media Release Form
PDF template
Release form granting permission for media use related to a choral scholarship application for young singers.
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School Fee Waiver Form
PDF template
A form for parents or legal guardians to request a waiver of school activity fees based on financial need
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School Immunization Clinic Parental Consent Form
PDF template
A parental consent form for adolescent vaccinations during a school-based immunization clinic, requiring parent/guardian approval and screening.
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PREVENTATIVE HEALTH CARE EXAMINATION FORM
PDF template
A comprehensive health examination form for students entering Kentucky public schools, documenting medical history, immunizations, and health screenings.
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Risk Assessment Form
PDF template
A comprehensive risk assessment document addressing coronavirus risks and mitigation strategies for an educational institution
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Pupil Personal Accident Report Form
PDF template
A comprehensive form for reporting and claiming medical expenses for student accidents at school
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School Waiver Form Extracurricular Activities
PDF template
A school waiver form for students participating in sports and extracurricular activities, outlining liability and insurance requirements.
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VSU Participation Agreement And Waiver Form (Minor Participant)
PDF template
A comprehensive waiver and release form for minors participating in university programs, covering liability and medical protocols.
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Special Consideration Medical Form
PDF template
A medical form for students seeking special consideration due to acute illness or injury at the University of Canterbury.
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Adult Minor Medical Release
PDF template
Medical release and emergency contact form for participants in international travel or mission trips
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Scouts Go Solar Application Form
PDF template
Application and data protection consent form for participation in Scouts Go Solar program, including personal and scout group details.
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Take Charge Follow Up, Diagnostic, And Treatment Training (ODH Form No. 274C)
PDF template
Training document for healthcare professionals on completing the Take Charge! Follow up, Diagnostic, and Treatment form.
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PRESCRIPTION SUBMISSION FORM
PDF template
A form for submitting and tracking pharmaceutical prescriptions with specific endorsement and signing requirements.
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Media Release And Consent Form
PDF template
A consent form authorizing Seven Counties Services to use an individual's photographs, videos, audio, or interview content for promotional purposes.
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San Diego County Public Health Laboratory Test Requisition Form
PDF template
A comprehensive form for submitting medical test specimens to the San Diego County Public Health Laboratory with patient and specimen details.
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Student Transfer Request Form Medical, Emotional, Or Social Adjustment
PDF template
A form for requesting student school transfer based on medical, emotional, or social adjustment needs, requiring documentation from a healthcare provider.
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Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
PDF template
Legal document waiving liability for risks associated with skiing and snowboarding activities at Optimist Hill ski resort in Saskatchewan.
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Wateree Hounds Waiver And Indemnity Release Season 2020.2021
PDF template
Legal document releasing Wateree Hounds from liability during equestrian activities and trail rides.
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MN BCA Background Check Consent Form
PDF template
Consent form for criminal background check for employees or volunteers at a non-profit organization or school.
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Maryland Uniform Consultation Referral Form
PDF template
A comprehensive form for medical consultation and referral between healthcare providers, capturing patient, carrier, and referral details.
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Volunteer Assumption Of Risk Release Of Liability And Indemnity Agreement
PDF template
Legal document for volunteers at Second Harvest Food Bank of Orange County, outlining risk assumption and liability release for volunteer participation.
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CONSENT TO DISCLOSURE OF TAX RETURN INFORMATION
PDF template
A legal form allowing taxpayers to authorize disclosure of their tax return information to specified parties with consent duration.
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Group Insurance Disability Claim Form
PDF template
A comprehensive form for submitting a disability insurance claim by an employee, physician, and employer or plan administrator.
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Medical Claim Form
PDF template
A comprehensive medical claim form for reimbursement of medical expenses through Seib Insurance & Reinsurance Company in Qatar.
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SEL 531 Fax Or Email Vote Secret Ballot Waiver Form For Military And Overseas Voters
PDF template
Form allowing military and overseas voters to submit ballots via fax or email, acknowledging waiver of ballot secrecy.
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Medical Assessment Form (PA 635)
PDF template
A form used by the Pennsylvania Department of Public Welfare to assess an individual's medical condition and ability to participate in employment and training activities.
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SENECA MEDICAL FORM
PDF template
Medical form for collecting student health information, tuberculosis screening, and immunization history at Seneca College.
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PBCI SENIOR MEDICAL TRAVEL FORM
PDF template
Comprehensive medical screening form for senior travel participants detailing health status, medical history, and emergency contact information.
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Childcare Liability Waiver Form
PDF template
A comprehensive document outlining childcare policies, procedures, and a legal liability waiver for a fitness center's childcare services.
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Service Agreement
PDF template
A service contract for veterinary care detailing payment terms and client responsibilities for horse medical treatment.
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Diventures Service Agreement
PDF template
A service agreement for equipment repair and maintenance at Diventures dive centers, including liability release and service terms.
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QBC Hematology System Service Agreement
PDF template
A service agreement for QBC hematology diagnostic equipment repair and replacement services with single or double swap options.
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SERVICE WAIVER FORM
PDF template
A form for employees to document previous employment and retirement plan eligibility when waiving a waiting period for retirement plan enrollment.
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Veterinary Muscle And Nerve Test Request Form
PDF template
A specialized form for veterinarians to request detailed muscle and nerve diagnostic tests for animals.
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Veterinary Muscle And Nerve Test Submission Form
PDF template
Comprehensive form for submitting veterinary muscle and nerve diagnostic tests with detailed pricing and payment options.
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Evaluation Description Script Virtual Workshops
PDF template
Description of document procedures for virtual workshop participation, including privacy policy, liability waiver, and survey information collection.
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Supervision Of Normal Pregnancy And Delivery Form
PDF template
A healthcare form for documenting pregnancy details, medical information, and patient consent for medical services related to pregnancy and delivery.
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Santa Fe Conservation Trust Medical Form
PDF template
A comprehensive medical form for participants of Santa Fe Conservation Trust trips, collecting health history and emergency contact details.
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Registration Of Written Advance Health Care Directive
PDF template
Official state form for registering, amending, or revoking an advance health care directive with the California Secretary of State.
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Medical Reimbursement Account Claim Form
PDF template
Comprehensive instructions for submitting medical expense reimbursement claims through a Medical Reimbursement Account (MRA)
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Background Check Consent Form
PDF template
A consent form for conducting criminal background checks, typically used for volunteer or placement screenings.
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Waiver Of Requirement For Soils Testing
PDF template
A document allowing property owners to waive formal soils testing requirements for single-family residential construction in Scottsdale, Arizona.
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Data Protection Consent Form
PDF template
A consent form for employees, volunteers, and lay ministers to provide consent for data processing and media usage in a church parish context.
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Application For Approval Of Research Proposal
PDF template
A comprehensive form for submitting and obtaining approval for a research proposal at Shahid Gangalal National Heart Centre.
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Shannon Center Membership Form
PDF template
Membership registration and liability waiver for the Shannon Center at Saint Xavier University fitness facility
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DA 325 Shared Leave Request Form
PDF template
A form for state employees to request shared leave benefits for serious medical conditions affecting themselves or family members.
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Shared Leave Request Form
PDF template
A form for City of Tacoma employees to request shared leave due to severe illness, injury, or medical condition that has exhausted their accrued leave.
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UF Student Health Care Center (SHCC) Exposure Ordering Form
PDF template
Medical form for ordering laboratory tests following potential blood-borne pathogen exposure for UF employees and students
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Shelter Admission Discharge For Animal
PDF template
A comprehensive form documenting an animal's admission to a shelter, including owner and pet details.
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UWM Animal Resource Center Animal Shipping Form Exporting
PDF template
A form for documenting the export of research animals, including their health status, genetic modifications, and shipping details.
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INTERNATIONAL HEALTH SERVICE SHIPPING FORM
PDF template
A form for documenting and shipping medical and personal supplies for International Health Service logistics
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UWM Animal Resource Center Animal Shipping Form Receiving
PDF template
A form for documenting animal shipment details, health status, and research-related information for animal transfer between research facilities.
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Instructions For Shipping Samples For Porphyria Testing
PDF template
Comprehensive instructions for collecting, processing, and shipping blood and urine samples for porphyria laboratory testing at the University of Texas Medical Branch.
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SHOE MODIFICATION ORDER FORM
PDF template
A detailed form for ordering customized shoe modifications for patients with specific medical needs or conditions.
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Shop Safety Assessment Form
PDF template
A comprehensive checklist for evaluating safety practices, documentation, and workplace conditions in industrial or laboratory shop environments.
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In Case Of Emergency Contact Form
PDF template
A form to be placed on a child's car seat with emergency contact and medical information for first responders.
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Patient Intake Form
PDF template
Comprehensive medical intake form for chiropractic patients, collecting personal, employment, medical, and lifestyle information.
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Granite School District Short Term Disability Claim Form
PDF template
A form for Granite School District employees to file a claim for short-term disability benefits, documenting medical condition and work absence details.
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Short Term Disability Claim Form
PDF template
A policy document detailing short-term disability benefits for employees, including eligibility, compensation, and leave requirements.
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Short Term Disability Income Claim Form
PDF template
A document used to file a claim for short-term disability benefits, requiring details from the employee, employer, and attending physician.
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Short Term Disability Leave Request Form
PDF template
A form for employees to request short-term disability leave, including tracking PTO and leave details.
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Shot Clock Waiver Form
PDF template
A form allowing applicants to waive statutory deadlines for various city planning and development permits under Local Government Code Chapter 212.
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School Based Supplemental Health Services Consent Form
PDF template
A comprehensive health information and consent form for students at Saint Martin de Porres High School, collecting medical history and insurance details.
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School Based Supplemental Health Services Consent Form
PDF template
A comprehensive health information and consent form for students at Saint Martin de Porres High School, collecting medical history and insurance details.
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Preparticipation Physical Evaluation Physical Examination Form
PDF template
Comprehensive medical evaluation form for athletes to assess physical fitness and health status prior to participation in sports activities.
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Consent For Use Of Images Form
PDF template
A consent form by Sidian Bank for using individuals' images and personal data for promotional and marketing purposes.
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Signatures On A Consent Form
PDF template
Document explaining signature procedures for consent forms in RSS, detailing changes effective February 2024.
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Specialist International Medical Graduate (SIMG) 2024 Application For Fellowship
PDF template
Application form for international medical graduates seeking fellowship with the Royal Australian and New Zealand College of Psychiatrists (RANZCP)
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Catastrophic Leave Request Form
PDF template
Form for employees to request catastrophic leave of absence for personal or family medical reasons, in accordance with West Virginia state regulations.
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SELF INSURED SERVICES COMPANY REIMBURSEMENT FORM
PDF template
A form for employees to submit medical expense claims for reimbursement through a self-insured employer benefit program.
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Client Application Form
PDF template
Confidential client intake form for medical and contact information at a recovery center specializing in brain and spinal cord injury rehabilitation.
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Personal Health History Form
PDF template
A comprehensive health form required for students participating in SIT Study Abroad programs, consisting of multiple parts to be completed by students and medical providers.
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Confidential Medical History
PDF template
Comprehensive medical form capturing patient's personal and family health history, with a specific focus on eye-related conditions and general health status.
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Skate Park Acknowledgement, Waiver And Release Of Liability
PDF template
Legal document releasing the Town of River Bend from liability for risks associated with skateboarding at their skate park.
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SkillZone DIY Workshop Release And Liability Waiver Form
PDF template
A liability release form for participants in a DIY workshop, covering consent, safety acknowledgment, and media usage rights.
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NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A medical release form for wrestlers with skin lesions, developed by the NFHS Sports Medicine Advisory Committee to provide guidelines for participation with skin conditions.
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NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A standardized medical form developed by the National Federation of State High School Associations to manage skin lesions and communicable skin disorders in wrestling.
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DIAANFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
PDF template
A standardized medical release form for wrestlers with skin lesions, developed by the National Federation of State High School Associations to protect athletes and manage communicable skin disorders.
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Perreard Professional Billing Insurance Form
PDF template
A medical billing form for collecting patient and insurance information for professional healthcare services.
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MEDICAL HISTORY FORM
PDF template
Comprehensive medical form for collecting patient personal information, medical history, vaccination status, and surgical history.
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Fluorochromes Slide Digitization Submission Form
PDF template
A form for submitting slides for digital scanning and imaging with details about project, contact information, and scanning specifications.
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Emergency Contact And Medical Release
PDF template
A medical release and emergency contact form for participants in a service-learning program, allowing medical treatment authorization.
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Salt Lake Regional Medical Center Student Orientation Module
PDF template
Comprehensive orientation guide for healthcare students preparing for clinical placement at Salt Lake Regional Medical Center.
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SLTD Premium Waiver Form
PDF template
Form to terminate a Supplemental Long Term Disability premium waiver when an employee returns to work.
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Trapeze Experience Registration Agreement Form
PDF template
Registration and medical consent form for a flying trapeze course with participant medical information and liability release
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Trapeze Experience Registration Agreement Form
PDF template
Registration and medical consent form for a flying trapeze course, including participant details, medical information, and image release
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Small Business First Waiver Form
PDF template
A form for requesting exemption from the Small Business First policy for non-federally funded purchases between $10,000 and $250,000.
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Small Miner Waiver Information
PDF template
Detailed guidelines for filing a small miner waiver for mining claims with the Bureau of Land Management.
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Form 2E Smallpox Case Household And Primary Contact Surveillance Form
PDF template
A CDC form for tracking and documenting household or primary contacts of a smallpox case, including daily temperature monitoring and contact information.
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Small Purchase Waiver Form
PDF template
A form used to document exceptions to multiple vendor quote requirements for university purchases between $20,000 and $99,999.99.
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DoctorS Examination Form
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Medical examination form to assess child's fitness for participating in a Soap Box Derby race.
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Management Benefits Fund Superimposed Major Medical Plan (SMMP) Claim Form
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A comprehensive medical claim form for submitting healthcare expenses and patient information to the Management Benefits Fund insurance plan.
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SMS QuestionnaireSupplement Pre Award V6.0
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A document providing guidance for completing the SMS Questionnaire for aviation safety management and risk reduction processes.
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Snow Fun YOUTH Informed Consent And Parental Consent Form
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A consent form for youth participation in Snow College's SnowFun courses and programs, requiring parent/guardian and participant signatures.
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Vision Group Insurance Form
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A comprehensive form for submitting vision insurance claims, to be completed by employees and vision care providers.
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REFERRAL FORM BARIATRIC SURGERY
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A comprehensive medical referral form for patients seeking bariatric surgery evaluation, detailing patient requirements and documentation needs.
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ParentalGuardian Consent Form
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A form requesting parental permission to publish a child's image and personal information on church media platforms and publications.
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Social Media Consent Form
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A form allowing patients to consent or decline having their information and images shared on social media platforms by Proformance Rehab.
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Software Waiver Form
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Form for obtaining procurement specialist approval for software or ICT purchase using ProCard or Vendor Payment Request Form
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Medical Form For US Programs
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Comprehensive medical form for Special Olympics athletes to document health information, conditions, and assistive needs.
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Special Olympics Incident Report Form
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Comprehensive form for documenting accidents and injuries during Special Olympics events, capturing details about the injured person, incident, and witnesses.
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SOM Family Campaign Payroll Deduction Form
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Payroll deduction form for making charitable contributions to the School of Medicine Scholarship Campaign
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Media Release Form
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A form granting permission to SOMOS Community Care to use an individual's image in various media and publications.
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Media Release Agreement
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A legal document granting permission for Sonoran University to photograph, interview, and use media of an individual for various university purposes.
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SoonerCare Health Risk Assessment
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A comprehensive medical assessment form collecting patient demographics, health status, family information, and medical conditions for SoonerCare patients.
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Sleep Out Saturday 2018 Waiver
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Legal release and assumption of risk form for Sts. Joachim and Ann Care Service's Sleep Out Saturday event
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Media Consent And Release Form
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A document granting permission for the use of an individual's image, audio, or video recordings for specified purposes.
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VISION CLAIM FORM
PDF template
Insurance claim form for submitting vision-related medical service claims and patient information.
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VISION CLAIM FORM
PDF template
A standard form for submitting vision insurance claims with patient and insurance details.
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SPARK Waiver And Media Release Form (Required)
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A legal release form for participants in the University of Iowa's Space Physics and Astronomy Kamp, covering liability, risks, and media usage rights.
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Sacroiliac Joint Injection Consent Form
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Medical consent form for sacroiliac joint injection procedure detailing treatment, risks, and patient acknowledgment.
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DIVING MEDICAL HISTORY FORM
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A comprehensive medical history questionnaire designed to assess an individual's fitness for scuba diving and training programs.
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Special Category Volunteer Medical Packet
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A comprehensive medical packet for volunteers detailing health screening and immunization requirements for special category volunteers at a healthcare facility.
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SB 1383 Special Conditions Waiver Application
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Application for commercial and multi-family properties to request a waiver from organic waste collection requirements under California Senate Bill 1383.
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PLATELET TEST REQUISITION FORM
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A comprehensive form for collecting patient information and requesting platelet-related laboratory testing at Cincinnati Children's Hospital Medical Center.
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Program Instruction Specific Consent Requests
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Provides instructions for obtaining special immigrant juvenile status and specific consent requirements for unaccompanied alien children in HHS custody seeking state court jurisdiction.
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Specialty Referral Form
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A medical referral form for patients being referred to a specialist within the Holston Medical Group network.
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Specialty Care Referral Form
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A medical referral form for patients seeking specialized dental care at Creighton Dental Clinic.
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Specialty Referral Form
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A medical referral form for specialty healthcare services, including periodontics and endodontics referrals.
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Supply Order Form For Diagnostic Immunology Collection Kits
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Form for ordering diagnostic testing supply kits for blood, urine, and multi-test swab specimens from the West Virginia Department of Health Office of Laboratory Services.
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PIN Specimen Inventory Form
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Laboratory documentation form for tracking and recording specimen details, storage locations, and collection information for research study specimens.
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Out Of State Tuition Waiver Application
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Application form for students seeking waiver of out-of-state tuition fees, typically for sport club members.
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SLU Sports Medicine Medical History Form
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Comprehensive medical history form for sports medicine patients documenting personal health details, injuries, and medical background.
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Preparticipation Physical Evaluation (Interim Guidance) Physical Examination Form
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A comprehensive medical examination form for athletes or participants to assess physical fitness and health status before participating in sports or activities.
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Sports Physical Examination Form
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Medical form required for student-athletes to participate in team sports, documenting medical history and fitness for athletic participation.
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REGISTRATION FORM
PDF template
Registration and parental consent form for minors participating in a sports event at Lincoln Memorial University.
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SPOUSAL CONSENT FORM
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A legal form allowing a spouse to provide consent for a retirement plan distribution or loan, with options for notarization or plan administrator witness.
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Spouse Disability Benefit Application Form
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Insurance claim form for spouse disability benefits, requiring comprehensive personal and medical information for claim assessment.
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Substantive Policy Statement 15
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Policy guidelines by the Arizona Medical Board for establishing residency when applying for professional licensing under A.R.S. 32-4302.
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Swampscott Public Schools EmergencyMedical Form
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A comprehensive form collecting student medical, contact, and emergency information for the school year 2018/2019.
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Special Placement Volunteer Process
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Detailed process for recruiting, screening, and onboarding volunteer personnel at Upstate Medical University
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Strawberry Recreation District Rental Agreement, Waiver And Release
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A comprehensive form for renting facilities at Strawberry Recreation District, covering event details, facilities, and liability considerations.
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Catastrophic Withdrawal Request Medical
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A form for students requesting withdrawal from classes due to serious medical circumstances that prevent course continuation.
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Student Recreation And Wellness RU Outdoors Medical Screening Form
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Confidential medical screening form for students participating in outdoor recreational activities to ensure safety and assess participant health conditions.
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Form SSA 3288 Consent For Release Of Information
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A form allowing individuals to consent to the release of their personal records or records of a minor or legally incompetent adult to specified parties.
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Consent To Be In SSM Health News Stories, Educational Materials Or Promotions
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A consent form allowing SSM Health to use an individual's image, interview, or name for educational and marketing purposes.
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Waiver Of Liability, Indemnification, And Medical Release FORM ST 2
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Legal document releasing Hennepin Technical College from liability for potential risks during sponsored activities or field trips.
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ST. ALOYSIUS ACADEMY ATHLETICS PHYSICAL EXAMINATION FORM
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Confidential medical form for student-athletes to document health history and physical condition for participation in school sports.
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Standardized Application For Pathology Fellowships
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A comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
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Standardized Application For Pathology Fellowships
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Comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
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ORTHOPAEDIC SPINE INSTITUTE NEW PATIENT INTAKE FORM
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Comprehensive medical intake form for new patients experiencing spine-related pain or conditions, capturing detailed pain assessment and medical history.
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Standardized Application For Pathology Fellowships
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Comprehensive application form for medical professionals seeking specialized pathology fellowship training
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Standardized Application For Pediatric Pathology Fellowship
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Comprehensive application form for individuals seeking a pediatric pathology fellowship position, collecting personal, educational, and professional details.
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Standardized Application For Pathology Fellowships
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Comprehensive application form for medical professionals seeking specialized pathology fellowship training across various subspecialties.
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Standardized Application For Pathology Fellowships
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Comprehensive application form for physicians seeking specialized pathology fellowship training across multiple subspecialties.
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Standard Notice And Consent Documents Under The No Surprises Act
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Official documents for providing notice and consent requirements for nonparticipating healthcare providers and facilities under the No Surprises Act.
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USA Health Referral Form
PDF template
A comprehensive referral form for patient transfer and medical consultation between healthcare providers at USA Health University of South Alabama.
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Volunteer Agreement, Release And Waiver Of Liability
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Legal document outlining volunteer responsibilities, risks, and liability release for Habitat for Humanity volunteers.
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Standing Order Request Form
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A form for requesting specialized medical transportation services with scheduling and patient details for healthcare-related appointments.
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Virginia Standing Order Request Form
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A form for requesting medical transportation services with detailed patient and trip information for Medicaid recipients.
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St. AnneS School Field Trip ParentGuardian Consent Form And Indemnity Agreement
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A consent form for parents/guardians to authorize their child's participation in walking field trips during the school year and provide emergency contact information.
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Physician Referral Form
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Confidential form for referring children and adolescents for behavioral and developmental health services.
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State Employee Tuition Waiver Instructions
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Guidelines for state employees to receive tuition waivers for up to six credit hours per semester at eligible institutions.
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State Employees Tuition Waiver Form
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A form for state employees to request tuition waiver at St. Johns River State College for up to six credit hours per semester.
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State Of Maryland Employee And Retiree Health And Welfare Benefits Program Health Assessment
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A comprehensive health survey for Maryland state employees and retirees to assess their current physical and mental health status.
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Statewide Innovative Waiver Pathway Compliance Form
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A compliance form for Ohio colleges and institutions seeking to implement alternative College Credit Plus pathways with waived student eligibility requirements.
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STD 101C GROUP SHORT TERM DISABILITY (STD) CLAIM FORM
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A comprehensive form for employees to file a short-term disability claim, requiring detailed information about their medical condition and work status.
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STD CASE REPORT FORM
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Official medical reporting form for documenting sexually transmitted disease cases and patient information in New Jersey.
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Short Term Disability Claim Form Report Of Continued Disability
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A form for participants to report ongoing short-term disability and provide medical update information for continued claim processing.
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Disability Claims Accident Sickness (AS)Short Term Disability (STD)Salary Continuance
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A comprehensive form for filing disability claims, including sections for employer, employee, and physician/provider information.
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Your Disability Benefit Claim
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Comprehensive guide and forms for applying for disability insurance benefits through Standard Insurance Company.
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Short Term Disability Claim Form Statement Of Employee
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A comprehensive form for employees to file a short-term disability claim, providing personal, employment, and medical information.
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Short Term Disability Claim Form Physician Statement
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A medical form for physicians to document a patient's disability claim details for Anthem Life Insurance Company.
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Tree Risk Assessment Form
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A comprehensive form for assessing potential risks and health of trees in forest and recreational areas.
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Camp Liability And Medical Release Form
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A comprehensive liability and medical release form for camp participants, covering medical treatment, property damage, and media usage consent.
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Sterilization Consent Form Notice
PDF template
Notice to physician providers about updated sterilization consent form requirements and availability.
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Sterilization Consent Form (MA 31)
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Medical Assistance Bulletin announcing an updated sterilization consent form for healthcare providers.
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PATIENT INFORMATION AND MEDICAL RELEASE FORM (FORM I)
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A comprehensive form for collecting patient insurance details, medical authorization, and payment responsibility for Bioness Inc.
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St. Jude Affiliate Clinic Referral Form
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A referral form for patients seeking medical consultation at St. Jude Affiliate Clinic at Huntsville Hospital for Women and Children
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HCO Grant Application Form
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A form for healthcare organizations to request educational support grants from Astellas for healthcare professionals to attend scientific congresses.
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St. MaryS Bedfont Data Protection Consent Form
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A form for individuals to provide consent for receiving communications and participating in church activities while protecting personal data privacy.
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Consent To Treat Form
PDF template
A legal document allowing healthcare providers to treat a patient and use their protected health information for treatment and operational purposes.
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Letter Of Recommendation Waiver Form
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A form allowing applicants to waive or retain their right to access a letter of recommendation during an application process.
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Risk Assessment Form
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A risk assessment document for managing fire and heat-related safety during youth scouting activities involving stoves and heat sources.
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St. PaulS Episcopal School Medical Examination Form
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A comprehensive medical examination form for students at St. Paul's Episcopal School, requiring physician documentation of student's health status and immunization records.
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Stryker Benefits Summary
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Comprehensive benefits summary for Stryker employees, including location-specific healthcare provisions and insurance options.
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Stress Risk Assessment Form
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A comprehensive form for evaluating workplace stress factors and developing control measures for employee well-being.
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HistologyImmunohistochemistry Laboratory Requisition
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A medical laboratory form for submitting tissue specimens for histological and immunohistochemical analysis.
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Privacy And Electronic Communications Consent Agreements
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A comprehensive consent form for privacy and electronic communications by Strawberry Loans, detailing information collection, use, and disclosure practices.
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Meningitis Waiver Form
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A waiver form for students to acknowledge risks of not receiving meningococcal meningitis vaccination, as required by New York State Public Health Law.
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Student Activity Liability Waiver Form
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A legal document that releases Whitworth University from liability for student activities, projects, and travel, requiring voluntary participant acknowledgment of risks.
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Student Activity Or Club Release And Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
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A legal document allowing students to participate in university activities by acknowledging and accepting potential risks and liability terms.
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STUDENTVISITOR WAIVER FORM
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A waiver form for students and visitors at Pennsylvania State University and Penn State Milton S. Hershey Medical Center, detailing liability and workers' compensation terms.
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Student Athlete Drug Testing Consent Form
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Consent form for student athletes at Concordia University, Nebraska agreeing to drug and alcohol testing as part of athletic participation.
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Student Athlete Drug Testing Consent Form
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Consent form for student athletes to participate in alcohol and drug testing program at Concordia University, Nebraska.
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Preparticipation Evaluation History Form
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Comprehensive medical history and health screening form for athletes prior to sports participation.
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AU Student Background Check Consent Form
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Consent form for criminal history background check for Augusta University students, allowing police department to verify criminal history information.
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AU Student Background Check Consent Form
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Consent form for Augusta University students to authorize a criminal background check by the university police department.
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Consent Form For Use And Disclosure Of Student Information
PDF template
A consent form allowing educational programs to collect, use, and disclose student personal and health information for placement purposes.
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Student Consent Form
PDF template
Form allowing students to authorize release of their educational records to a designated third party in compliance with FERPA guidelines.
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Student Consent Form Template
PDF template
A template document for obtaining student consent, potentially for various educational or administrative purposes.
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Student Consent For Release Of Information To ParentsThird Parties
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A form allowing students to grant or revoke third-party access to their educational and financial records in compliance with FERPA guidelines.
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Student Drug Testing Consent Form
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A consent form for random drug testing of students participating in extracurricular activities in Lafayette County public schools.
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Student Waiver For Educational Cultural Trips
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Waiver form for students participating in university-sponsored off-campus events, acknowledging personal liability and trip details.
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Student Employee Waiver Form
PDF template
A form allowing student employees to request exceptions to standard employment criteria such as GPA requirements or work hour limitations.
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Student Employee Waiver Form
PDF template
Form for students to request exceptions to standard employment policies, including work hours and GPA requirements.
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Student Activity Student Representation Fee WaiverRefund Request
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Form for students to request waiver or refund of voluntary student activity and representation fees at Contra Costa College.
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Student Fee Waiver Form
PDF template
A form allowing students to request waiver of specific student fees for a particular semester.
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Student Medical Information And Emergency Notification Form
PDF template
A medical information and emergency contact form for student participants in regional science competitions.
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Student Handbook Agreement Form
PDF template
A form requiring parent and student signatures to acknowledge understanding of school policies and procedures.
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Student Hazard Report Form
PDF template
A form for students to report safety hazards, risks, or unsafe practices at Forsythes Training facility.
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STUDENT HEALTH EXAMINATION FORM
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A comprehensive health form for students entering kindergarten, fifth, and ninth grades requiring physical and dental examination documentation.
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Confidential Student Health HistoryExamination Form
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Comprehensive medical and health background documentation for school-aged children, completed by parents/guardians and medical practitioners.
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Student Health SurveillanceRisk Assessment Form For Vertebrate Animal Exposure
PDF template
Form for students to document health risks and immunization status when working with live vertebrate animals at Appalachian State University.
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Student Incident Report Form
PDF template
A form to document student incidents, exposures, and potential infectious disease or environmental hazards in clinical settings.
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Disability VerificationMedical Release Form
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Medical form for students with disabilities enrolling in Adapted Physical Education and Aquatics courses at Citrus College.
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Student Luminary Awards Waiver Form
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A waiver form allowing the university to verify student academic and conduct records for award nomination purposes.
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Student Personal Information ReleaseSchool And District Publications
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A form allowing parents/guardians to grant or deny permission for publishing student photos and names in school and district publications.
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Student Media Release Form
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A form granting permission for students to be photographed, videotaped, or interviewed by school-related groups.
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PENNSYLVANIA MUSIC EDUCATORS ASSOCIATION STUDENT MEDICAL INFORMATION FORM
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Comprehensive medical form for students participating in music education events, collecting critical health and emergency contact information.
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Student Health Information Form
PDF template
Comprehensive form collecting student health details, medical needs, allergies, and contact information for school or event purposes.
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Student Medical Form
PDF template
Confidential medical form for students in nursing and allied health programs, requiring personal health history, immunization records, and physical exam documentation.
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Student Medical Form
PDF template
Annual medical form for students to document health history, screenings, and physician certification for school participation.
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Student Medical Form For Programs That Require Health Forms
PDF template
Medical form required for students in health science programs to participate in clinical experiences, detailing health status and immunization requirements.
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Student Medical Form For Programs That Require Health Forms
PDF template
Required medical form for students in health science programs to verify physical and emotional capability for clinical experiences.
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Student Medical History Form
PDF template
A comprehensive medical form for collecting student health information, medical history, and parental consent for medical treatment.
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Eagle Bluff Student Medical Information And Permission Form
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A comprehensive medical form for student participation in Eagle Bluff activities, collecting health details and medication information.
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Health Form Requirement Checklist
PDF template
Comprehensive health form checklist for students at Packer, detailing required documentation and submission process for medical records.
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Release And Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
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Legal document releasing La Crosse Area Builders Association from liability during a construction career showcase and interactive event.
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STUDENT PETITION MEDICAL SUPPORT FORM
PDF template
A form for students to request grade or course removal based on medical conditions affecting academic performance.
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Physical Examination Form
PDF template
Medical examination form for students to document health status and medical clearance for participation in health career or athletic programs.
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PREVENTATIVE HEALTH CARE EXAMINATION FORM
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Comprehensive health examination form for students entering Kentucky public schools, documenting medical history, immunizations, and screening results.
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Photo And Media Release Form
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A legal document granting Syracuse University London Program permission to use submitted materials across various media platforms without further notification.
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Student Profile Vehicle Registration Parking Waiver
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A comprehensive form for students to register their vehicle, provide medical information, and potentially waive parking fees at their educational institution.
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Student ProjectActivity Proposal Form
PDF template
A form for students to propose and get risk management approval for projects or activities not part of regular course curriculum.
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Student International Activity Proposal Form
PDF template
A form for Hobart and William Smith Colleges students to propose and get approval for independent international activities with institutional risk management review.
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Description Of Student Duties And Medical Release Form
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Medical release form for Hennepin Technical College emergency service course students detailing physical requirements and health clearance.
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StudentS Medical History
PDF template
A comprehensive medical history form required for new students at the University of Montevallo, collecting personal and health information.
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Student Travel And Field Trip Expectations And Consent Agreement
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A consent form for university students participating in sponsored trips, outlining travel expectations and requirements for both domestic and international travel.
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Participation And Self Transportation Agreement Release And Waiver Of Liability Assumption Of Risk A
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Legal document for participants to acknowledge risks, waive liability, and provide consent for university-related activities and transportation.
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Seton Hall University Off Campus Activity Student Voluntary Participation Waiver And Release And Eme
PDF template
A legal waiver for students participating in off-campus university activities, outlining risks, responsibilities, and release of liability.
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Student Volunteer Application Form
PDF template
A comprehensive application form for students interested in volunteering for a research team, particularly in medical or healthcare-related fields.
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Parental Consent For Medical Treatment
PDF template
A comprehensive form for parents to provide medical information and consent for their child's medical treatment when parents are not immediately available.
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MEDICAL RELEASE FORM
PDF template
A medical consent form allowing treatment of a minor child in the absence of a parent or guardian, with space for medical and contact information.
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The Sub Contractor Bid Waiver Form
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Instructions for generating and accessing a subcontractor bid waiver form for contracts over $25,000.
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Egg Submission Form
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Form for submitting eggs for AGID testing of avian influenza in non-commercial backyard poultry settings.
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Subscriber Claim Form
PDF template
Insurance claim form for submitting medical service bills to Blue Cross Blue Shield of Massachusetts for reimbursement.
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Media Release And Consent Form
PDF template
A legal document granting the State of Alaska permission to use an individual's photographic, video, or written content for various state purposes.
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Pediatric Sudden Cardiac Death Risk Assessment Form
PDF template
A comprehensive screening form to assess potential cardiac risks in children by examining patient and family medical history related to heart conditions.
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SUGGESTED REFILL REQUEST FORM
PDF template
Form for requesting refills of medical equipment with patient and supplier information verification.
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Summer 2022 Youth Arts Technology Program Medical Release Form
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Medical release form for children participating in summer arts technology program at Westchester Community College
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Summer 2024 Field Trip Waivers
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Legal waiver for parents/guardians consenting to children's field trips to Chicago Dogs Baseball Game and Wheeling Aquatic Center.
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2020 Lorado Taft Day Camp Parental Consent Form And Waiver Of Liability Agreement
PDF template
Parental consent form for children participating in the Lorado Taft Day Camp, including medical authorization and camp guidelines.
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Medical Release Form
PDF template
Medical authorization form for minors participating in county recreation programs, allowing emergency medical treatment and releasing liability.
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Summer Camp Medical Form
PDF template
Medical form for documenting student health information and parental consent for summer camp participation and medical treatment.
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Taylor University Summer Camp Participation Waiver, Release Of Liability And Medical Authorization A
PDF template
Legal document waiving liability and authorizing medical treatment for participants in Taylor University Summer Camp.
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Media Release Form
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Parental consent form allowing photography, interviewing, and video recording of a child for public use by the University of Houston School of Theatre & Dance.
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Waiver, Indemnification, And Media Release Form
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Legal document releasing Houston Christian University from liability for potential injuries during event participation.
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Child Physical Examination Form
PDF template
Medical form documenting a child's physical health, immunization history, and medical examination details for academic summer school programs.
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MEDICAL FORM 2018 SUMMER PROGRAMS
PDF template
A comprehensive medical form for participants registering for summer youth programs, collecting personal, emergency contact, and health information.
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Sound To Sea Day Camp Medical Form
PDF template
Comprehensive medical form for children attending day camp, collecting health history, emergency contacts, and medical information.
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Summit Orthopaedics Patient Intake Form
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Comprehensive medical intake form for patients seeking orthopaedic care, collecting personal, medical, and injury-related information.
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APPLICATION FOR NEUROLOGY SUBSPECIALTY FELLOWSHIP
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A comprehensive application form for medical professionals seeking subspecialty fellowship training in neurology tracks such as Clinical Neurophysiology and Vascular Neurology.
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SupervisingCritic Teacher StipendWaiver Election Form
PDF template
A form for supervising teachers to elect either a cash stipend or a tuition waiver for their educational supervision work.
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WPHL Supply Order Form
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Order form for laboratory requisition forms, collection kits, individual components, mailers, and outbreak supplies from Wyoming Public Health Laboratory.
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SUPPLY ORDER FORM
PDF template
Order form for veterinary diagnostic laboratory supplies including blood tube boxes, formalin jars, and bovine testing kits.
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Photo Video Submission Form
PDF template
Form for submitting photographic or video content related to surfing for archival at Randall Library, UNCW.
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SURGE Detroit River Agreement For Release Of Liability, Assumption Of Risk, And Indemnification
PDF template
A comprehensive liability release form for participants in SURGE event activities involving boat and maritime-related experiences.
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Surgery Billing Form For WorkSafeNB Claimants
PDF template
Medical billing form for surgical procedures claimed through WorkSafeNB's workers' compensation program.
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Surgery Scheduling Cancellation Request
PDF template
A medical form used to request cancellation of a previously scheduled surgical procedure at a healthcare facility.
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Surgical Biopsy Submission Form
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A diagnostic form for submitting surgical biopsy specimens to the Atlantic Veterinary College for veterinary pathology analysis.
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Consent For Surgery Operation Procedure(S)
PDF template
A legal document detailing patient consent and understanding of surgical risks and procedures.
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Pathology Requisition (Surgical And Non GYN)
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A comprehensive medical form for submitting surgical and non-gynecological pathology specimens for laboratory analysis and diagnostic evaluation.
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Veterinary Diagnostic Center Surgical Pathology Submission Form
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A detailed submission form for veterinary surgical pathology specimens and diagnostic testing.
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SURF SIMULATOR RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK AND INDEMNITY AGRE
PDF template
A legal document releasing liability for participants using a surf simulator, outlining potential risks and participant acknowledgment.
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Veterinary Immunological Reagents Needs Survey Form
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A survey form for veterinary researchers to identify and prioritize needed immunological reagents across different species and research areas.
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HEALTH HISTORY MEDICAL FORM
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Comprehensive medical history and fitness form for assessing participant health and potential medical concerns for outdoor activities.
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Enhanced Best Management Practices For Construction At High Risk Sites
PDF template
Detailed guidelines for construction activities at high-risk environmental sites in Ventura County, focusing on stormwater protection and environmental preservation.
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Swimming Pool Waiver And Release Of Liability Form
PDF template
A legal document that releases property owners from liability for risks associated with swimming pool usage during a vacation stay.
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SWIM Access To Care Print Booking Form Quick Reference Guide
PDF template
A step-by-step guide for printing a booking form from the Provider's Office module in the SWIM healthcare system.
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Self Declaration Form
PDF template
A form for volunteers to declare any criminal history and acknowledge liability waivers for Kamehameha Schools.
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SYMPTOM SURVEY FORM
PDF template
A comprehensive form for patients to self-report medical symptoms across multiple health categories with severity levels.
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Symptom Survey
PDF template
A detailed medical form tracking patient symptoms across multiple body regions including neurological, musculoskeletal, and pain indicators.
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SYNAGIS CONNECT Patient And Prescriber Information Form
PDF template
Medical form for patient and prescriber information to support prescription and reimbursement for SYNAGIS (palivizumab) medication
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Universal Referral Form
PDF template
A comprehensive medical referral form for specialty pharmacy services, collecting patient, insurance, and medical criteria information.
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Risk Assessment Form
PDF template
A comprehensive form for documenting and assessing potential risks across various operational areas of the Texas A&M University System.
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Texas AM University System Risk Management And Insurance Matrix
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A comprehensive matrix for identifying, evaluating, and managing potential risks associated with university activities and events.
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SYSTEMS SURVEY FORM
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A comprehensive medical survey form documenting patient symptoms, physiological responses, and health indicators across multiple body systems.
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SYSTEMS SURVEY FORM
PDF template
Comprehensive medical symptoms survey covering multiple physiological systems and health indicators
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Travel Release Form
PDF template
A legal document releasing Texas State University from liability for potential injuries or damages during university-sponsored travel.
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TELLURIDE ACADEMY ACKNOWLEDGMENT AND ASSUMPTION OF RISKS RELEASE AND INDEMNITY AGREEMENT
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Comprehensive risk acknowledgment and liability release document for adult and minor participants in Telluride Academy activities
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BRI Transboundary Animal Disease Workforce Development Fellowship Opportunity Announcement
PDF template
A two-year fellowship program training researchers to conduct research on transboundary animal diseases in high-containment laboratory environments.
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2017 ParentS Guide To Health Services At Taft
PDF template
A comprehensive guide for parents outlining health services and medical resources available at Taft School's Martin Health Center.
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Team America Insurance Form
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Insurance coverage form for Team America rocket team participants to provide evidence of insurance for launch site owners and sponsors.
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The Adolescent Leadership Council Contact Form
PDF template
A form for collecting contact information and medical details for adolescent participants in a leadership program
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WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION FORM
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Legal document releasing TAMIU Rec Sports Department from liability during recreational activities and authorizing potential medical treatment.
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WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION FORM
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Legal document releasing liability for participation in recreational activities at Texas A&M International University.
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Preparticipation Physical Evaluation
PDF template
Medical examination form required for high school athletic participation in Texas private and parochial schools
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ONE TIME TAP Waiver Form
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A form allowing students to request a one-time waiver of academic progress requirements for New York State educational financial aid.
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ONE TIME TAP Waiver Form
PDF template
A form allowing students to request a one-time waiver of academic progress requirements for TAP eligibility with specific documentation and explanation.
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TARC3 Medical Form (Cognitive Limitations Or Psychological Conditions)
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A medical form used to evaluate an applicant's cognitive abilities and capacity to safely use public transportation services.
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TARC3 Medical Form (General Medical Or Physical Disability)
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Medical form for assessing an individual's ability to safely use public transportation, completed by a healthcare professional.
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Alberta Consent Form
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A form used to authorize or cancel a representative's access to confidential corporate income tax account information with Tax and Revenue Administration (TRA)
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Hospital Discharge Approval Request Form
PDF template
A medical form used by the New York City Department of Health and Mental Hygiene to process and approve hospital discharges for tuberculosis patients.
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Tuberculosis Risk Assessment Form (Required)
PDF template
Medical form for screening tuberculosis risk through history, symptoms, and exposure assessment
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TUBERCULOSIS RISK ASSESSMENT FORM
PDF template
A comprehensive screening form to assess an individual's risk of tuberculosis based on contact history and travel to high-incidence countries.
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Tuberculosis (TB) Screening Questionnaire
PDF template
A screening questionnaire for students to assess tuberculosis risk factors, required by Barton Community College for enrollment.
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Tuberculosis Screening Form
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Medical screening form for tuberculosis risk assessment for students or employees requiring TB testing or chest x-ray.
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Traditional Cat Association Work Request And Price Sheet
PDF template
Comprehensive pricing document for cat breeding registration, forms, and website services offered by the Traditional Cat Association.
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Accident Waiver And Release Of Liability Form
PDF template
A legal document releasing liability for participants in an outdoor service event, acknowledging risks and waiving potential claims.
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Kingwood Oxford School Team Tobati Student Travel Form
PDF template
A comprehensive travel consent and health information document for students participating in an international school trip to Paraguay.
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Comparative Medicine Program Technical Services Request Form
PDF template
A form for requesting veterinary and research support services for animal research procedures in a laboratory setting.
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Student Consent For Technology Use
PDF template
Consent form for students in grades 4-8 outlining responsible technology and internet usage guidelines at school.
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Student Consent For Technology Use
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A consent form for primary students (Grades JK-3) and their parents regarding responsible technology use in school.
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Liability Release, Waiver, And Indemnity Agreement For Personal Computer Support Services
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A legal agreement outlining terms and conditions for computer support services provided by American University's Office of Information Technology.
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TEEX Firefighter Recruit Academy Medical Release Form
PDF template
A comprehensive medical form for firefighter recruits to document health history and current medical status prior to academy enrollment.
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Travel Form
PDF template
Medical form for patients seeking travel health advice and vaccination recommendations before international travel.
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Liability Release, Waiver, Indemnity, And Service Level Agreement For Personal Computer Support Serv
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A legal document outlining the terms and conditions for Southern Oregon University's IT support services for personal computers
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Telehealth Consent Form
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Consent form for patients engaging in telehealth psychotherapy services, outlining risks, confidentiality, and patient responsibilities.
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APPENDIX A. STANDARD CONSENT FORMINFORMATION SHEET TEMPLATE
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A template document providing guidance for creating a standard consent form for research studies, outlining key sections and recommended language.
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Consent Form Template For Field Trip (If Participant Is Under 18 Years Old)
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A comprehensive consent and liability waiver form for minors participating in a field trip, covering medical consent, liability release, and promotional rights.
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FORM E Human Subjects Consent Form Sample (IRB)
PDF template
A standard consent form for participation in a research study, outlining participant rights, study details, and voluntary participation.
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YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A medical release form for youth and junior volleyball players, collecting essential medical information and emergency contact details.
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Template Photography Consent Form Minors
PDF template
A template document outlining consent requirements for photographing minors, including usage rights and legal considerations for photography consent.
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Inbuilt Temporary Incapacity Benefits For Defined Benefit Division Members
PDF template
Detailed guide explaining temporary incapacity benefits for Defined Benefit Division members, including eligibility requirements and claim process.
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Temporary Permanent Disability Claim Form
PDF template
A comprehensive insurance claim form for temporary and permanent disability claims, to be completed by the policyholder and employer.
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Risk Assessment Form
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Risk assessment document for activities at Mounts Bay Academy in Penzance, identifying potential hazards and control measures.
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Psychological Testing Referral Form
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A comprehensive form for requesting psychological testing and evaluations for patients of all ages, including patient and insurance information.
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Outreach Services Test Requisition
PDF template
Medical test requisition form for pathology and laboratory testing at MD Anderson Cancer Center with multiple diagnostic testing options.
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Sample Discharge Form
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A comprehensive form for tracking a shelter guest's health status, medical needs, and transportation requirements during evacuation or return.
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Tick Submission Form
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Official form for submitting ticks found on human hosts for medical testing and investigation by the Texas Department of State Health Services.
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Tick Submission Form
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Official form for submitting human-extracted ticks for medical testing and investigation by state health services.
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Text Messaging Consent Form
PDF template
A consent form outlining risks, conditions, and client responsibilities for text message communication with Deschutes County.
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NEW PATIENT INTAKE FORM
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Comprehensive medical intake form for new patients, collecting personal health information, symptoms, and medical history for Dr. William S. Crawford.
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The 44th Othello Meijin Sen Registration Agreement Form
PDF template
Registration form and consent agreement for participants in the 44th Othello Meijin-sen tournament, covering personal information usage and media rights.
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Student Medical Form
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A medical form for collecting student health information, emergency contacts, and medical permissions for Ocala Civic Theatre
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PRESCRIPTION REFERRAL FORM
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A comprehensive medical form for referring patients to various physical, occupational, and speech therapy services with multiple treatment options.
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RINJ Peer Review Chart Audit Form
PDF template
A comprehensive medical chart review form used by the RINJ Foundation for documenting and validating patient medical records and procedures.
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The Role Of A Surety In The Context Of A Construction Project
PDF template
A webinar discussing surety bonds, their role in construction projects, and differences from traditional insurance.
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Wellness Center Health Information Form
PDF template
A confidential medical form for collecting student health and family medical history for Sage Colleges
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Volunteer Consent Agreement Form
PDF template
Consent form outlining volunteer policies and requirements for working at a women's safe house organization.
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Heartburn And Reflux Center Intake Form
PDF template
Medical intake form for patients experiencing heartburn, reflux, and related gastrointestinal symptoms at Texas Health Heartburn and Reflux Center.
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PRE AUTHORIZATION FORM FOR PROMETHEUS Thiopurine Metabolites
PDF template
Medical pre-authorization form for requesting laboratory services related to thiopurine metabolite testing from Prometheus Laboratories.
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McKenzie Institute International Thoracic Spine Assessment
PDF template
Comprehensive medical assessment form for thoracic spine condition, capturing patient history, symptoms, and clinical observations.
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Threat Risk Assessment Protocol
PDF template
A comprehensive policy for identifying, assessing, and managing potential threats within the college community.
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Tick Submission Form
PDF template
A form for submitting tick specimens for identification and testing, primarily for ticks that have fed on humans.
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Tissue Share Request Form
PDF template
A form for requesting post mortem tissue collection from deceased animals for research purposes.
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Non Emergency Medical Travel Reimbursement
PDF template
A guide for Medicaid recipients explaining how to claim reimbursement for non-emergency medical travel expenses including mileage, lodging, and meals.
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Parental Consent Form For Student Travel
PDF template
A consent form for parents/guardians of 16-17 year old students traveling to the UK for study at The Language Gallery.
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Trail Life USA ADULT Weekend Health And Medical Record
PDF template
Comprehensive medical and health information form for adult participants in Trail Life USA weekend activities
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The Leadership Experience 2022 Medical Release Form
PDF template
A medical release form for participants in the Oklahoma State University Leadership Experience program, allowing officials to seek medical attention if needed.
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The Leadership Experience 2020 Medical Release Form
PDF template
A medical release form for participants in the Oklahoma State University Leadership Experience program, authorizing emergency medical treatment and collecting contact information.
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Accident Waiver And Release Of Liability Form
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A legal document releasing Trail Design Specialists, LLC from liability for potential risks and injuries during a crew leader training event.
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Proof Of Delivery Of Temporomandibular Joint Disorder (TMD) Oral Appliance
PDF template
Document acknowledging patient receipt and understanding of a custom oral appliance for temporomandibular joint disorder treatment.
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Train Mountain Railroad Museum Participant Release
PDF template
Legal release form for participants entering Train Mountain railroad property, waiving liability for potential injuries or damages.
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Transcranial Magnetic Stimulation (TMS) Pre Authorization Form
PDF template
Medical pre-authorization form for requesting Transcranial Magnetic Stimulation (TMS) treatment, requiring patient and medical coding details.
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Authorization For Treatment Form
PDF template
Form for medical examinations, physical tests, drug screening, and workplace health services
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TOOTH REMOVAL CONSENT FORM
PDF template
Medical consent form detailing risks and patient understanding of tooth removal procedure and potential complications.
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Consent Form For Collecting Personal Data InFrom European Union
PDF template
A consent form by Touro College for collecting and using personal data from EU individuals in compliance with GDPR regulations.
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Town And Country Animal Clinic Medical History Form
PDF template
Comprehensive veterinary intake form documenting a pet's current health status, symptoms, and medical history.
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MEDIA RELEASE FORM
PDF template
A legal form granting permission for the Tallahassee Police Department to use an individual's image or a minor's image for various media and promotional purposes.
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TissueBloodNucleic Acid Request Form
PDF template
A form for researchers to request tissue, blood, and nucleic acid samples from the University of North Carolina Tissue Procurement Facility.
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TRINITY PROFESSIONAL GROUP REGISTRATIONCONSENT TO TREAT FORM AND HIPAA
PDF template
A comprehensive medical registration form for patient intake, consent to treatment, and insurance information collection.
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TPH204 Medical Declaration Form Part 1
PDF template
Medical fitness declaration form for London taxi and private hire vehicle drivers, requiring medical assessment based on DVLA Group 2 standards.
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PRE AUTHORIZATION FORM FOR PROMETHEUS TPMT Enzyme
PDF template
A medical pre-authorization form for requesting laboratory services related to TPMT enzyme testing at Prometheus Laboratories Inc.
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Declaration Of Tobacco Use Or Non Tobacco Use Form
PDF template
Form documenting tobacco use status for University of Texas System medical plan members with potential premium surcharges based on tobacco usage.
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Kansas 3rd Party Consent Form
PDF template
A form authorizing a third party to obtain an individual's vehicle registration and driver's license record information.
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Trading Partner Agreement
PDF template
A legal agreement establishing terms for trading partners in the energy services industry, specifically for Electronic Data Interchange (EDI) compliance.
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Waiver In Respect Of Time Limit For Assessment, Reassessment Or Determination
PDF template
A form for corporations to waive time limits for tax assessments, reassessments, and tax credit determinations under the Alberta Corporate Tax Act.
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Notice Of Revocation Of Waiver
PDF template
Official form for corporations to revoke a previously signed tax assessment waiver under the Alberta Corporate Tax Act.
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Workers Compensation Waiver Form
PDF template
A legal form allowing sole proprietors or independent contractors to waive workers' compensation coverage rights in Arizona.
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Waiver, Release Of All Claims And Hold Harmless Agreement
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Legal document releasing Barrington Park District from liability for potential injuries during park district programs and activities
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Transfer Of Patient Record Consent Form
PDF template
A legal form authorizing the transfer of personal dental health records between healthcare providers in compliance with health information protection regulations.
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BONENT Exam Transfer Request
PDF template
Form for transferring between different BONENT examination formats and locations with associated processing fees.
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DHS Early Intervention Transportation Billing Form
PDF template
A billing form for transportation services provided to children in early intervention programs in Illinois.
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Data Protection Consent Form
PDF template
Consent form for processing personal health data for cross-border healthcare services under the European Cross-Border Healthcare Directive.
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Application Form Trauma, Emergency Services And Surgical Critical Care Research Fellowship
PDF template
Application form for medical professionals seeking a research fellowship in trauma, emergency services, and surgical critical care.
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Travel AcknowledgementWaiver Form For Stetson Field Trip, Event, Function Or Course Related Travel
PDF template
A waiver form for students participating in university-sponsored field trips, events, or course-related travel, acknowledging risks and liability.
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Access2Care Travel Assessment Form
PDF template
Medical form to determine appropriate transportation services for individuals with disabilities or medical conditions
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Travel Booking Form
PDF template
Comprehensive form for patients seeking travel health advice and vaccination consultation prior to international travel.
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Travel Consent Form For Minor Child
PDF template
A legal document providing parental consent for a minor child to travel with an authorized adult to a specified destination.
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Travel Consent Form
PDF template
A consent form for minor athletes to travel with the rowing club, including medical authorization and transportation details.
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Pre Travel Assessment Form
PDF template
Comprehensive medical form for travelers to assess health status, medical history, and vaccination record before travel.
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Travel Medical History Questionnaire
PDF template
Comprehensive questionnaire for documenting medical and travel details for international travelers from Saint Xavier University Health Center.
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Travel Medical Release Form
PDF template
Medical information release form for cancer patients seeking air travel support through the Cassie Hines Shoes Cancer Foundation (CHSCF)
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Travel Form Auto
PDF template
Form for patients to request reimbursement for medical transportation expenses related to medical appointments.
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Release Of Liability And Assumption Of Risks
PDF template
Legal document waiving liability for a student's voluntary international trip participation, acknowledging potential risks and dangers.
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Travel Risk Assessment Form
PDF template
Comprehensive form for collecting traveler medical history and trip details prior to travel
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Travel Risk Assessment Form
PDF template
A comprehensive form for evaluating health risks and medical history for travelers before an international trip.
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Short Term Disability Claim Form
PDF template
Insurance claim form for documenting a short-term disability, including personal information, medical details, and potential compensation sources.
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2C Risk Assessment Form
PDF template
Comprehensive risk assessment form for youth rehabilitation program tracking client background, placement history, and potential risk factors.
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Referral Form
PDF template
A comprehensive medical form for documenting patient wound details, diagnosis, and referral information for healthcare professionals.
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Student Athletic Eligibility Form
PDF template
Form for determining student athletic participation eligibility and consent for school sports involvement.
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University Of Arkansas Athletic Tryout Medical Documentation
PDF template
Required medical documentation for students attempting to join University of Arkansas intercollegiate athletic teams.
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AlcoholDrug Test Consent Form
PDF template
Consent form for employees submitting to alcohol and drug testing as a condition of employment with the State of Nevada.
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TS Alliance Clinic Ambassador New Patient Contact Form
PDF template
A contact form for individuals and families connected to Tuberous Sclerosis Complex (TSC) to receive information and support services.
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Comparative Medicine Technical Service Request Form
PDF template
Form for requesting technical services and supplies from the University of Maryland Baltimore's Comparative Medicine department
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Registration Form 2021 2022 Dance Season
PDF template
Registration form for dance classes at Triple Threat Performing Arts Company, including payment authorization and informed consent.
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Tuberculosis (TB) Risk Assessment Form
PDF template
Medical form to assess patient's risk and history of tuberculosis exposure and infection.
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TUBERCULOSIS RISK ASSESSMENT FORM
PDF template
A comprehensive medical form for screening and assessing individual risk factors and history related to tuberculosis infection and exposure.
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Tuition Waiver Authorization And Transcript Release
PDF template
A form for teachers seeking tuition waiver authorization and transcript release for educational advancement at La Sierra University or Pacific Union College.
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Faculty Staff Scholarship Waiver Application
PDF template
Application form for Bethel University employees seeking tuition scholarship benefits for academic programs
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Out Of District Student Tuition Waiver Form
PDF template
Form for parents/guardians to request tuition waiver by volunteering at Candor Schools for a minimum of 12 hours per month.
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On Line Tuition Waiver Form
PDF template
Step-by-step guide for completing and submitting an online tuition waiver form for employees, spouses, or dependent children.
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Fort Lewis College Tuition Waiver Request Packet
PDF template
A comprehensive guide for Fort Lewis College employees to request tuition waivers for taking courses with specific eligibility and application requirements.
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Tuition Waiver Form
PDF template
Form for employees or retirees to request tuition waiver benefits for themselves or dependents at the University of Toledo.
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Tuition Waiver Proof Of Dependency Affidavit Instructions
PDF template
Detailed instructions for determining tax dependent eligibility for tuition waiver under IRC Section 117(d)
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Authorization To Release Written Information, Photographs, Film Or Videotape
PDF template
Legal document authorizing the Texas Workforce Commission to use personal information, photographs, and recordings for various media purposes.
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Twinbrook Swimming Pool Membership Application 2022
PDF template
Membership application for Twinbrook Swimming Pool with various membership options and rates for individuals and families.
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Temescal Wellness Of New Hampshire Patient Intake Form
PDF template
Intake form for qualifying medical cannabis patients in New Hampshire, collecting patient and caregiver information and legal acknowledgments.
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Media Release Form
PDF template
Legal document authorizing University of Alabama at Birmingham to use an individual's name, likeness, voice, or performance for educational materials and publications.
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Project ProposalRisk Assessment Form
PDF template
A comprehensive form for documenting project details, safety risks, and facility access requirements for laboratory or design projects.
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UB 04 Claim Form Instructions
PDF template
Comprehensive instructions for completing the UB-04 healthcare claim form with detailed guidance on form locator entries and billing specifications.
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UB 04 CMS 1450
PDF template
Official standardized form used by healthcare facilities for medical billing and insurance claims processing.
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UB92 Claim Form
PDF template
A standardized medical billing form used by healthcare facilities to submit patient treatment and billing information.
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U CAN Pre Project Form
PDF template
A form for potential U-CAN users to submit project proposals and collaboration details in the biomedical research domain.
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Sample Submission Form
PDF template
Form for submitting veterinary medical samples to UC Davis Veterinary Medical Teaching Hospital's Clinical Diagnostic Laboratory for testing.
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Research Inquiry Form UC Davis Veterinary Medical Teaching Hospital
PDF template
A form for researchers to submit details about a clinical study involving veterinary diagnostic testing at UC Davis Veterinary Medical Teaching Hospital.
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Standardized Application For Pathology Fellowships
PDF template
Comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
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UCI Travel Approval Form
PDF template
Form for obtaining pre-approval or exception for travel during pandemic conditions, requiring detailed risk assessment and justification.
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Authorization For Use Or Disclosure Of Health Information
PDF template
A medical authorization form allowing patient to authorize disclosure of personal health information to specified recipients
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Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document releasing University of California San Diego from liability for potential risks during an activity or program participation.
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Standardized Application For Pathology Fellowships
PDF template
A comprehensive application form for medical professionals seeking specialized pathology fellowship training in various subspecialties.
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2024 2025 WAIVER CANCELLATION FORM
PDF template
Form for UC San Diego students to cancel their health insurance waiver and enroll in UCSHIP student health insurance plan.
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Participant Consent, Release And Waiver Of Liability
PDF template
Legal document releasing University of Florida from liability for participation in youth events or activities
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Waiver Of Liability And Hold Harmless Agreement
PDF template
Legal document releasing University of Florida from liability for potential injuries while using exercise equipment in the UFIT space.
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Fish Disease Diagnostic Lab Submission Form
PDF template
Form for submitting animal specimens to the University of Florida's Tropical Aquaculture Laboratory for diagnostic testing.
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Uganda Travel Form And Waiver 2024
PDF template
Travel registration and liability waiver for a guided trip to Uganda, covering trip details, medical information, and booking terms.
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UnitedHealthcare Medical Claim Form
PDF template
A form used to request payment for eligible healthcare services that have already been received from an out-of-network provider.
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Medical Claim Form
PDF template
A form for submitting medical expense claims to UnitedHealthcare for reimbursement of eligible healthcare services.
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Waiver Of Premium
PDF template
Instructions for employers and employees on how to process a Waiver of Premium for life insurance during total disability.
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Medical Claim Form
PDF template
A form for submitting out-of-network medical claims and requesting payment for eligible healthcare services
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Pre Participation Health Examination Form
PDF template
A comprehensive health form required for students participating in athletic activities, including medical history and physical examination documentation.
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Authorization For Use Of Image, Voice, Performance, Artwork Or Likeness
PDF template
A legal authorization allowing University of Houston-Downtown to use an individual's image, voice, artwork, or biographical information for educational and promotional purposes.
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Meningococcal (Meningitis) Waiver Request
PDF template
A waiver form for college students to opt out of meningococcal vaccination with acknowledged understanding of disease risks.
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Yandisa Benefit Application Form
PDF template
Application form for patients seeking medical benefits through Umvuzo Health Medical Scheme's Yandisa program, requiring comprehensive personal and medical information.
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UIHC Student Checklist Form
PDF template
Comprehensive checklist for students completing clinical rotations at University of Iowa Hospitals & Clinics, covering health screenings, requirements, and training
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UIMUI Report Form
PDF template
A comprehensive form for reporting unusual incidents or major unusual incidents involving individuals in care settings.
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UIMUI Report Form
PDF template
A comprehensive form for documenting unusual incidents and major unusual incidents involving individuals in a care or support setting.
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UJS 022 Instruction For Order On Motion To Waive Filing Service Of Process Fee Form
PDF template
Instructional guide for requesting waiver of court filing and service of process fees in South Dakota circuit courts
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Diagnostic Imaging Department Ultrasound Requisition
PDF template
Medical form for documenting and requesting ultrasound diagnostic imaging across various body regions and systems.
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Outside Group Facilities Use Indemnity Agreement
PDF template
Agreement outlining terms and conditions for outside groups using church facilities or vehicles, including risk acknowledgment and indemnification.
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Member Medical Claim Submission Form
PDF template
A form for submitting medical insurance claims for reimbursement of eligible medical expenses when providers do not file claims directly.
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UPMC Sports Medicine Authorization For Release Of Protected Health Information
PDF template
A consent form allowing UPMC Sports Medicine to share athlete medical information with authorized personnel for treatment and administrative purposes.
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Medical Claim Form
PDF template
A form for submitting medical reimbursement requests for services from non-network providers under Uniform Medical Plans.
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Member Claim Submission Form
PDF template
A form for submitting medical and vision service claims to UMR for reimbursement by members.
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VIM Mission Team Form Instructions
PDF template
Comprehensive instructions for mission team leaders detailing required documentation, forms, and submission guidelines for mission trips.
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UNCG Exposure To BloodInfectious Material Incident Investigation Form
PDF template
A detailed form used to document and investigate workplace exposure to blood or infectious materials, tracking incident details, routes of exposure, and recommended preventive actions.
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UNC Health Endocrinology Physician Referral Form
PDF template
Medical referral form for patients requiring endocrinology consultation, specifying patient information and diagnostic requirements.
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NEW PATIENT MEDICAL HISTORY FORM
PDF template
Comprehensive medical history form for new patients to document personal health, screening, vaccination, and family history.
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Skagway Recreation Center Weight Room Cardio Room Equipment Use Waiver
PDF template
A waiver for children and teenagers to use the weight and cardio room at the Skagway Recreation Center, outlining usage rules and parental consent.
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SUBSTITUTIONEXCEPTIONWAIVER FORM (Undergraduate)
PDF template
A form for undergraduate engineering students to request course substitutions, exceptions, or waivers from degree requirements.
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Artist ApplicationAgreement
PDF template
A document for artists to apply and agree to liability terms when participating in Buttonwood Art Space activities.
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ParentS Or GuardianS Agreement Of Waiver Of Liability, Indemnification, And Medical Release
PDF template
A legal document for parents or guardians to acknowledge risks and release liability for a minor's participation in an activity.
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2023 24 PermissionWaiver Emergency Information Form Minor
PDF template
A comprehensive permission and emergency contact form for minors participating in church activities, including liability waiver and medical information.
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Special Olympics Unified Sports Participation Form
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Registration and liability waiver form for minor participants in Special Olympics Unified Sports programs
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Maryland Uniform Consultation Referral Form
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A standardized form for healthcare providers to request medical consultations, referrals, and services between healthcare providers and facilities.
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Uniform Consultation Referral Form
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A standardized form for healthcare providers to submit patient referrals and consultation requests through CareFirst insurance plans.
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Unique Services Reimbursement Program Claim Form
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A claim form for submitting reimbursement requests for unique healthcare services through Presbyterian Health Plan for the City of Albuquerque.
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Claim Information Form UnitedHealthcare StudentResources
PDF template
Insurance claim form for students to submit medical claims and accident information to UnitedHealthcare StudentResources
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Universal Enrollment Form
PDF template
Comprehensive enrollment form for medical, dental, and vision insurance covering active employees, retirees, COBRA, and surviving spouse participants.
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UNIVERSAL MEDICAL ASSESSMENT FORM FOR ALL TREATMENT CENTRES
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Comprehensive medical history form for documenting patient health conditions and personal information for adults and children.
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University Of Oregon Camps Accident Insurance Program
PDF template
Insurance policy providing primary accident medical benefits for University of Oregon camp participants with up to $25,000 coverage per injury.
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Undergraduate Academic Waiver Request
PDF template
A form for students to request academic policy exceptions or waivers at Eastern Illinois University.
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Unum Disability Claim Form
PDF template
A comprehensive claim form for submitting disability insurance claims with Unum Group subsidiaries, covering multiple types of disability benefits.
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Unusual Incident Reporting (UIR) Form
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A comprehensive form for reporting critical incidents involving children, including details about the child, incident type, and notifications.
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Urban Preparatory Academy Wichita Media Release Form
PDF template
A consent form authorizing Urban Preparatory Academy-Wichita to photograph, record, and use media featuring the signee or their children for institutional purposes.
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Course SubstitutionWaiver Form
PDF template
A form used to request course substitutions, equivalencies, or waivers for Associate Degree and Certificate of Achievement programs at Palomar College.
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DOG ADOPTION INTEREST APPLICATION
PDF template
A comprehensive form for individuals interested in adopting a dog, assessing suitability and household conditions.
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Partials Employee Consent Form
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A consent form allowing employers to file weekly unemployment claims and report employee information for partial unemployment benefits.
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DATA PROTECTION CONSENT FORM
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A consent form for GTBank Rwanda customers to authorize data processing and information sharing in compliance with EUGDPR regulations.
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Medical Summary Report Of Ministerial Candidate
PDF template
A confidential medical authorization form for ministerial candidates to release medical information to the Board of Ordained Ministry.
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Medical Release Form Accuracy Checklist
PDF template
A checklist to help verify the completeness and legal adequacy of a medical release form by reviewing seven key requirements.
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MEDICAL HISTORY FORM
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Comprehensive medical form for collecting patient health information, medical history, and emergency contact details.
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Eligibility Determination For Sliding Fee Discounts
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A form for patients to apply for healthcare service discounts based on income and family size at Long Island Select Healthcare, Inc.
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Referral Form
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A form for referring patients to ophthalmology services with multiple evaluation options and contact details.
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Sample Data Release Consent Form
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A consent form for parents/guardians to authorize release of student-level data for an educational research study.
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TMJ Patient Referral Form
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A medical referral form for patients seeking consultation at the IU School of Dentistry TMJ Institute for temporomandibular joint (TMJ) issues.
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UF OnCore Tip Sheet Upload IRB Approval And Consent Documents
PDF template
Instructions for uploading IRB approval letters and consent documents into the OnCore system for research studies.
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Flu Shot Reimbursement Form
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Form for members to request reimbursement for out-of-pocket flu shot expenses through UPMC Health Plan.
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Release From Responsibility, Assumption Of Risk, And Waiver
PDF template
Legal document releasing University of Portland from liability for participant activities and risks associated with university-sponsored events
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Participation, Waiver, And Release Of Liability Form
PDF template
A legal document that participants must sign to acknowledge risks and release the university from liability during an activity or event.
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SHEPHERD UNIVERSITY UPWARD BOUND PROGRAM EMERGENCY MEDICAL CONSENT CONTACT FORM
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Emergency medical consent and contact form for students participating in the Shepherd University Upward Bound Program, including medical history and medication information.
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Parental Authorization To Treat Minor Child When Not Accompanied By Parent Or Guardian
PDF template
Form allowing parents to authorize medical care for their child when the child is not accompanied by a parent or guardian
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TEST REQUEST
PDF template
Comprehensive medical test request form for various microbiological, viral, bacterial, and other diagnostic examinations.
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UAB Urology New Patient Referral Form
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Medical referral form for new patients seeking urology services at UAB Department of Urology in Birmingham, Alabama.
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Summer 2021 Enrollment Waiver Request
PDF template
Form allowing PhD students to request enrollment waiver for dissertation defense during COVID-19 restrictions in Summer 2021.
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CASE REPORT AND ACCIDENT INSURANCE CLAIM FORM
PDF template
A form for submitting accident insurance claims and reporting case details for medical expenses.
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USAV Youth Junior Volleyball Player Medical Release Form
PDF template
Medical release form for youth and junior volleyball players documenting health information and emergency contacts.
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YOUTH JUNIOR VOLLEYBALL PLAYER MEDICAL RELEASE FORM
PDF template
A comprehensive medical release and consent form for youth and junior volleyball players to capture health information, emergency contacts, and participation permissions.
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US Club Soccer Medical Waiver Form Printing
PDF template
Guide for US Club Soccer teams to print medical waiver forms through their GotSoccer team account.
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US Club Soccer Registration Form
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A consent form for registering a player with US Club Soccer, including personal and medical information.
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Emergency Medical Release Form
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A medical release form for riders to provide emergency contact and medical information for horse trials events.
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USE OF CLINICAL MATERIALS CONSENT FORM
PDF template
A consent form for CPE students allowing the use of their clinical materials for professional education, certification, and review processes.
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COB Prescription Co Pay Reimbursement Form
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A form for members to request reimbursement for prescription co-pay expenses through US Family Health Plan.
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Outpatient Referral Form
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A referral form for patients seeking specialist medical care within the USFHP network, requiring physician completion and details about the referral.
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Notification Of Injury
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Form for submitting medical accident claims to United States Fire Insurance Company with detailed instructions for claim submission.
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Participant Medical History And Examination Form
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Medical history and examination document required for U.S. Department of State international educational exchange program participants to confirm health status and medical clearance.
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Participant Waiver And Release Of Liability, Assumption Of Risk And Indemnity Agreement
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Legal document outlining liability waiver and risk assumption for United States Masters Swimming participants in swimming events and activities.
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USNA 153120 United States Naval Academy Media Release Form
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A form granting permission for the U.S. Naval Academy to use an individual's likeness in photographs and videos for promotional purposes.
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DS 3053 Statement Of Consent
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Form used to provide parental consent when one parent is unavailable during a minor's U.S. passport application process.
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PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
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Medical release and consent form for youth soccer players, providing emergency contact and health information.
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PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
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A consent and medical release form for youth soccer players, providing emergency contact and medical information for participation in soccer programs.
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PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
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A comprehensive medical release and consent form for youth soccer players, including emergency contact and medical information.
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Consent Form And Nonexclusive License For Publishing Works On The University Of Toledo Digital Repos
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A consent form granting the University of Toledo non-exclusive rights to publish and distribute an author's original work in digital format.
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Utility Providers Consent Form
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A form for obtaining consent from utility providers when proposing to encroach into a public utility easement or right-of-way in Georgetown, Texas.
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Monarch Project ParentGuardian Consent Form
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Consent form for parents/guardians to allow their child to participate in the Monarch Project educational support program.
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Media Release Form
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A form allowing or denying permission for the Universalist Unitarian Church of Waterville to use individual and minor photographs in church communications.
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University Of Washington Diving Medical History Form
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Confidential health screening form for diving applicants to assess medical fitness for diving activities and potential risks.
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Parental Consent Assumption Of Risk And Liability Waiver
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Legal document for parents to consent to a minor's participation in an activity and assume potential risks and liabilities.
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Catastrophic Leave Request Form
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A form for UW System employees to request extended unpaid leave due to serious illness or family medical needs.
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ADA Dental Claim Form Completion Instructions
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Comprehensive instructions for completing the American Dental Association's dental claim form, detailing recent version changes and field completion guidelines.
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Group Short Term Disability Claim Form
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A comprehensive form for employees to file a short-term disability insurance claim with medical and employment details.
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MESA INVITE EXAM 6A6PLUS SHIPPING FORM
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Shipping form for tracking and documenting MESA (Multi-Ethnic Study of Atherosclerosis) exam samples and shipments.
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MESA INVITE BLIND DUPLICATE SHIPPING FORM
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A shipping document used for tracking and documenting shipments in the MESA research study.
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Vacation Donation Program Contribution Form
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A form allowing state employees to donate vacation or personal leave hours to colleagues experiencing medical costs or salary needs.
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COVID 19 Vaccination Consent Form
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A consent form for receiving COVID-19 vaccination under Emergency Use Authorization, detailing patient rights and information consent.
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VACCINATION DECLINATION WAIVER FORM
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Form for students, staff, and faculty in Health Sciences at Howard Community College to document vaccination exemptions or declinations.
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Athletes Medical Information Form
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Medical evaluation form for veterans participating in the National Veterans Golden Age Games, assessing physical fitness and health status for athletic events.
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Foreign Medical Program (FMP) Registration Form
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A government form for registering and processing medical programs for veterans receiving care outside the United States.
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Written Medication Consent Form
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A comprehensive form for parents and healthcare providers to authorize medication administration for children in child care settings.
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Varsity Student Athlete Physical Examination Form
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A comprehensive medical history and physical examination form for MIT intercollegiate varsity student athletes to assess their fitness for sports participation.
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Participant Liability Release And Waiver Form
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Legal release form for participants in cheer and dance events, releasing Varsity Spirit and associated organizations from liability.
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Prescription Reimbursement Claim Form
PDF template
A form for submitting prescription medication reimbursement claims, detailing patient, pharmacy, and insurance information.
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Valley ChildrenS Referral Form
PDF template
A comprehensive medical referral form for patient consultation and diagnostic services at Valley Children's healthcare facility.
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Test Requisition Form
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Medical laboratory test request form for collecting patient specimen information and ordering diagnostic tests
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CWD Sample Submission Form
PDF template
Form for submitting chronic wasting disease (CWD) samples for testing from hunted or farm animals.
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NDSU VETERINARY DIAGNOSTIC LABORATORY GENERAL SUBMISSION FORM
PDF template
A comprehensive form for submitting animal specimens and medical samples to a veterinary diagnostic laboratory.
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General Sample Submission Form
PDF template
A form for veterinarians to submit animal samples for diagnostic testing at Colorado State University's Veterinary Diagnostic Laboratory.
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Vehicle Lock Out Waiver Form
PDF template
Waiver form for Manawa Police Department vehicle lockout service with liability release and fee acknowledgment.
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Physician Referral Fax Form
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A comprehensive medical referral form for patient information, insurance details, and physician contact for vascular specialist consultation.
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Program Enrollment Form
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A comprehensive form for patient enrollment in a Pfizer healthcare program, collecting personal, insurance, and healthcare professional information.
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IRIS Vendor Claim Form
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Form for providers to submit non-HIPAA claims for IRIS-funded healthcare services.
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Venipuncture Procedure Checklist
PDF template
A comprehensive checklist for evaluating the proper technique and safety protocols for performing venipuncture (blood drawing)
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Vermont Advance Directive Form
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A legal document allowing individuals to specify healthcare preferences and designate a healthcare decision-making agent.
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Venus Legacy Informed Consent Form
PDF template
Informed consent document for Venus Legacy medical cosmetic treatment, outlining potential side effects, treatment protocol, and patient agreements.
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Disability Verification Form For Students With Physical AndOr Chronic Medical Disability
PDF template
A form used by physicians to verify a student's disability and functional limitations for requesting academic accommodations at University of Maryland Global Campus.
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NJCAA Physical Examination Form
PDF template
Medical evaluation form for student athletes to assess fitness for intercollegiate sports participation.
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RezDawg Rescue Veterinary Partners List
PDF template
A comprehensive list of veterinary clinics and care centers for RezDawg Rescue foster animals in Colorado.
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VET STEP CHECKLIST
PDF template
A checklist for applicants to Tuskegee University's College of Veterinary Medicine, detailing required application documents.
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Non Resident Waiver Form For Veterans, Spouse, And Dependents
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Form for veterans, spouses, and dependents to request in-state tuition rates at Texas A&M University-Corpus Christi based on federal educational benefits.
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Student Medical Form
PDF template
A comprehensive medical form for students to provide health history, insurance information, and medical details for college enrollment.
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Service Learning Forms For Virtual Volunteer Opportunities
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Instructional document for students participating in virtual volunteer opportunities at Evergreen Valley College's Service-Learning Program.
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Athletic ParticipationParental ConsentPhysical Examination Form
PDF template
A comprehensive form for student athletes to obtain consent and document eligibility for school sports participation.
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Out Of Network Reimbursement Instructions
PDF template
Detailed instructions for submitting out-of-network healthcare reimbursement claims to VBA, including required documentation and submission methods.
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Vision Claim Form
PDF template
A form for submitting vision care expenses for reimbursement through a health benefits plan.
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Personal Medical Info Form
PDF template
A comprehensive medical information form for students participating in a travel program, collecting health history and current medical details.
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U.S. Department Of State Academic Exchanges Participant Medical History And Examination Form
PDF template
Medical history and examination form required for international educational exchange program participants to confirm health status and medical clearance.
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PRE ADMISSION BOOKING FORM
PDF template
Comprehensive form for collecting patient and medical aid details prior to hospital admission, used for pre-authorization and patient registration.
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LCR.FORM.9 Referring Veterinarian Information
PDF template
A form for submitting animal remains for postmortem examination by veterinary pathologists, including details about the animal, owner, and referring veterinarian.
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Military Test Waiver
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A form allowing qualified service members to apply for a Commercial Driver License (CDL) with potential waiver of skills and knowledge testing.
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Patient Intake Form
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Comprehensive clinical intake form for evaluating patient's mental health, medical history, and current psychological functioning.
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Rehabilitation Referral Form
PDF template
A comprehensive form for referring veterinary patients to rehabilitation services at the University of Minnesota Veterinary Medical Center.
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Leave Request Form
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Comprehensive form for employees to request various types of leave, including medical, family, and military leaves.
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Instructions Online Abstract Submission Form
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Comprehensive instructions for submitting academic or medical conference abstracts, covering submission requirements and process details.
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Nutrition Referral Form
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A comprehensive form for veterinary professionals to request nutrition consultation and provide detailed patient medical information.
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Referral Form
PDF template
A comprehensive referral form for animal patients seeking specialized veterinary services at the University of Tennessee Veterinary Medical Center.
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VMSDEP TRANSFER REQUEST FORM
PDF template
Form for transferring education waivers for military survivors and dependents between educational institutions in Virginia
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VREP Waiver
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A legal document for participants in a motorcycle safety training course, releasing liability and acknowledging risks associated with the training.
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VNSNY Physician Referral Form
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Comprehensive medical referral form for home care services, collecting patient information, insurance details, and physician certification.
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Form 5 Special Love Medical Form For Volunteer
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Comprehensive medical and contact information form for camp volunteers, capturing health history, emergency contacts, and immunization details.
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Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement
PDF template
Legal document waiving liability and assuming risks for participation in music activities at Indiana University of Pennsylvania's Community Music School.
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Voluntary Participation Acknowledgement And Assumption Of Risk
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A legal document for volunteers at Mt. San Jacinto Community College to acknowledge risks and release the institution from liability.
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Rules And Requirements, Medical Consent, Release And Waiver Of Liability, Assumption Of Risk And Ind
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A legal document outlining terms of participation, risks, and liability release for university-related activities
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Voluntary Shared Leave Request Form
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A form for employees to request leave donated by other employees when they have exhausted their own leave credits.
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Voluntary Student Transportation Agreement For Field Trip And Excursions
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Legal document releasing Barstow Community College District from liability for student-arranged transportation during activities and field trips.
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Voluntary Waiver Form
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Legal document for participants to acknowledge risks and waive liability when engaging in activities at Providence College
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Providence College Voluntary Waiver Form
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A legal document for participants or parents/guardians to acknowledge risks and provide consent for activities at Providence College
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Volunteer Activity Waiver Form
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A comprehensive waiver form for volunteers to authorize participation and medical treatment in case of emergencies.
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Volunteer Activity Waiver Form
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A comprehensive waiver form for volunteers to release liability and provide emergency contact information for parish or school activities.
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Volunteer Agreement Form
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A volunteer agreement outlining the responsibilities and expectations for volunteers at the Skagit River Bald Eagle Interpretive Center.
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VOLUNTEER AGREEMENT FORM
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A comprehensive agreement outlining volunteer responsibilities, injury waivers, photo consent, and workplace policies for volunteers at North Country Food Bank.
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Adult And College Volunteer Application
PDF template
Comprehensive application for adult and college volunteers seeking to volunteer at various healthcare campuses in Georgia.
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Criminal History Consent Form For School Volunteers Application
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A consent form for potential school volunteers to undergo a criminal background check through Michigan's ICHAT system
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Volunteer Application And Waiver
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Application form for volunteers to register and provide personal information for participation in parks and recreation volunteer activities.
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Volunteer Application Form
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A comprehensive form for individuals interested in volunteering at various hospitals in the Mackay region of Queensland.
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Volunteer Background Check Consent Form
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A consent form for volunteers to undergo background investigations before serving in school settings.
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Volunteer Background Check Consent Form 2024 25
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A consent form for volunteers in the School District of Greenfield to undergo annual background investigations for school-related volunteering.
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Employee Board Member Committee Chair And Volunteer Consent Form To Criminal History Background Che
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A consent form for employees, board members, volunteers, and community members to undergo a criminal history background check through Michigan State Police's ICHAT system.
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Volunteer Consent Form
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A legal consent and liability release form for volunteers participating in activities at KVC Behavioral HealthCare.
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New Milford Health Department Volunteer Contact Form
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A form for collecting contact and professional information from potential health department volunteers
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VOLUNTEER EMERGENCY CONTACT FORM
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Form for collecting emergency contact details and medical transport authorization for volunteers
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Cuesta College RN Program Application Volunteer In Healthcare Or Non Profit Organization Verificatio
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A form for documenting volunteer hours for Cuesta College nursing program application, requiring a minimum of 200 volunteer hours between September 2022 and September 2024.
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Volunteer Registration Liability Waiver Form
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A comprehensive volunteer registration form and liability waiver for individuals interested in volunteering with the Disability Foundation and its affiliated societies.
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City Of Spokane Volunteer Agreement Waiver And Release Adult
PDF template
A formal document outlining the terms and conditions for volunteering with the City of Spokane, including service agreement, confidentiality provisions, and liability waiver.
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Appalachia Service Project (ASP) Volunteer Waiver And Consent Form
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Comprehensive waiver and consent document for volunteers participating in home repair and construction activities with Appalachia Service Project
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Agreement And Release For Student Coaching
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Legal document outlining participant responsibilities and consent for a coaching session with Coach Academy students.
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Minor Volunteer Consent Form
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A consent form for minors to volunteer at Miami University, detailing volunteer services and parental consent requirements.
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VolunteerS Waiver Of Liability And Release Of Claims
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Legal document authorizing criminal history records check and releasing liability for volunteers in school district.
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Data Protection Act Volunteer Consent
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A consent form for volunteers to allow Newcastle West End Foodbank to store and manage their personal information in compliance with data protection regulations.
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Volunteer Media Release Form
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Legal document granting media usage rights for a volunteer's image, voice, and likeness to On Point for College Inc.
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Volunteer Medical Form
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Medical form for collecting health details and emergency contact information for volunteers.
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PARENTAL CONSENT FORM FOR VOLUNTEERS
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Legal form granting parental permission for minors to volunteer at Towson University and releasing the university from liability.
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California State University Volunteer Release Form For Minors
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Legal form for parent/guardian consent and liability release for minors volunteering at California State University San Marcos.
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VOLUNTEER QUICK REGISTRATION FORM
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A registration form for volunteers to complete prior to starting their volunteer assignment, used by Occupational Health Services for medical clearance.
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Volunteer Release And Waiver Of Liability Form
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Legal document releasing United Food Bank from liability for volunteer activities and potential injuries during service.
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Life University Volunteer Service AgreementRelease Parental Consent Form
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A legal document outlining the terms and conditions for volunteering at Life University, including liability waivers and confidentiality agreements.
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Approval For Volunteers Participating In SOM Research Activities
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Form for authorizing volunteers to participate in research activities under faculty supervision at the UVA School of Medicine.
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Volunteer Time For DMS (Diagnostic Medical Sonography)
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Guidelines for volunteer hours and hospital observation requirements for Diagnostic Medical Sonography program admission
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Accident Waiver And Release Of Liability Form
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Legal document releasing liability for participation in activities, with specific focus on Louisiana SPCA event risks and responsibilities.
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Volunteer Waiver And Release Form
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Legal document for registering volunteers and releasing the city from liability for volunteer activities
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Volunteer Waiver Form
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Legal document outlining volunteer responsibilities, rights, and liability waivers for Genesee County volunteer program.
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MPS Volunteer Opportunity Participation Form
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A comprehensive form for volunteers to register for an MPS event, provide emergency contact information, and sign liability waivers.
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Child And Youth Group Volunteer Waiver Form
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Waiver form for volunteers participating in litter clean-up activities, acknowledging potential risks and releasing claims of injury.
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Volunteer Workers Limited Medical Cost Reimbursement Policy
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Policy outlining medical cost reimbursement for volunteer workers not covered by workers' compensation, with a maximum reimbursement of $5,000 for work-related injuries.
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General Release, Indemnity, And Waiver Of Liability
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A legal document releasing the Village of Ruidoso from liability for participation in recreational activities and granting permission for media use.
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Vintage Racers Group Vintage Racing License Medical Form
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Medical examination form for motorsport competition racing license applicants, focusing on physical fitness and safety capabilities.
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National Veterinary Accreditation Program Application Form
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Application form for veterinarians seeking national veterinary accreditation through the USDA Animal and Plant Health Inspection Service.
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Kit And Instrument Order Form
PDF template
Order form for diagnostic kits, instruments, and media from the USDA National Veterinary Services Laboratories
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Referral Form
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A specialized referral form for veterinary medical specialty consultations, used to transfer patient information between veterinary practices.
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Parasite Submission Form
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Official form for submitting parasite specimens to the National Veterinary Services Laboratories for analysis and research.
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VSP Member Reimbursement Form
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A form for VSP vision care members to request reimbursement for vision-related services and expenses.
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WAIVER FORM
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A form to decline participation in the VSP (Vision Service Plan) vision program offered by an employer.
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VYSA Medical Release Form
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A medical release form allowing emergency medical treatment for a youth soccer player by parent or legal guardian.
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Mental Health Transport Risk Assessment Form
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A form used to assess risks associated with mental health patient transportation and determine appropriate transport options.
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Vaccine Administration Record (VAR)Informed Consent For Vaccination
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A legal document providing informed consent for vaccine administration, detailing patient rights, provider responsibilities, and information sharing permissions.
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NEBRASKA PUBLIC SERVICE COMMISSION ELECTRIC TRANSMISSION LINES WAIVER FORM
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Official form for documenting consent and details for electric transmission line construction in Nebraska
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FAFSA WAIVER FORM
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A form allowing students or parents to opt out of filing the Free Application for Federal Student Aid (FAFSA)
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2021 2022 North Shore Academy Of Gymnastics Registration Form And Waiver
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Registration form and liability waiver for North Shore Academy of Gymnastics programs and activities
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Waiver Form And Acknowledgement Of Receipt Of Policies
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Patient form acknowledging financial responsibility for medical services not covered by insurance and agreeing to office policies.
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ACCIDENT WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION FORM
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Legal document waiving liability for vendors participating in events at the Canal Street Marketplace Facility.
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Waiver And Release Of Liability, Assumption Of Risk, And Indemnity Agreement
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Legal document releasing liability for participants in glacier diving activities, outlining risks and participant responsibilities.
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Waiver And Release Of Liability, Assumption Of Risk, And Indemnity Agreement
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Legal document waiving liability for diving activities and acknowledging potential risks associated with diving.
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Waiver And Rental Agreement Form
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A comprehensive waiver and rental agreement for clients renting Daybreak Point Bible Camp's island facility, outlining liability, risks, and client responsibilities.
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Newport Ave Preschool Kindergarten Waiver Application
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Application for a local educational agency to reopen for in-person instruction during COVID-19 pandemic
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WAIVER CANCELLATION FORM
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A form for students to cancel their university health insurance waiver for a specific academic quarter.
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University Of The Incarnate Word Waiver And Consent To Treat
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Legal document providing parental consent and waiver of liability for a minor's participation in a university or high school camp.
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Liability Release Form
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Legal document releasing Black Hills Paintball from liability for participants in paintball and related activities, including equipment damage and personal injury risks.
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Waiver Form For Promotion AndOr Tenure
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A legal document allowing faculty members to voluntarily waive rights to access external review information during promotion or tenure processes.
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New York Photo ID Waiver For Minors
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A legal form allowing parents or guardians to certify a minor's identity for identification purposes without a state-issued photo ID.
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Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
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Legal document waiving rights and assuming risks for participation in drop-in pickleball activities at Springbrook Multi-plex.
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COVID 19 POOL AREAS USE RELEASE AND WAIVER AGREEMENT
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Legal document outlining COVID-19 safety terms and conditions for pool area usage by community association members.
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Waiver Request To Use A Non Licensed Interpreter
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A form allowing the use of a non-licensed interpreter for communication services in New Hampshire
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ParentGuardian Permission Waiver Form For Minors
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A waiver form granting permission for minors to participate in volunteer activities at Daily Bread Food Bank, releasing the organization from liability.
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Waiver Of Health, Dental AndOr Vision Coverage
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A form allowing employees to decline health, dental, and vision insurance coverage offered by their employer.
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University Of North Dakota Waiver Form Instructions
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Detailed instructions for completing and submitting a waiver form at the University of North Dakota, including deadlines and submission process.
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Waiver Form ACL Complaint No. R2 2024 1032
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Waiver form for administrative civil liability complaint related to water quality regulations, requiring payment and waiving hearing rights.
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McHenry County College Fitness Evaluation Exercise Waiver Form
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A legal waiver for participants in McHenry County College's Fitness Education Program, releasing the college from liability for potential injuries or damages.
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Waiver Form
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A form for requesting a waiver from licensing requirements with fields for documentation and approval.
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Waiver Of Service
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Legal document allowing a defendant to waive formal service of a civil lawsuit summons and complaint in Nevada
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Release And Waiver
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Authorization form allowing the Timnath Police Department to obtain comprehensive personal background information for employment purposes.
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Waiver Request Secondary Student
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A form for high school students to request tuition and fee waivers for university courses at Southern Connecticut State University.
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Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
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Legal document releasing liability for participation in a Round Dance Shuttle Bus event with multiple collection points in Alberta, Canada.
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Waiver And Release Of Liability, Assumption Of Risk And Indemnity Agreement
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Legal document outlining liability release and risk acknowledgment for participants in United States Equestrian Federation events and activities.
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WAIVER, INDEMNIFICATION, AND MEDICAL TREATMENT AUTHORIZATION FORM
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Legal document releasing Prairie View A&M University from liability for participation in university-sponsored activities and acknowledging inherent risks.
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PARTICIPANT ACCIDENT WAIVERRELEASE OF LIABILITY FORM
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A legal document used to waive liability and obtain participant signatures for an event or activity.
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For Minors) WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AND PARENTAL CONSENT AND INDEMNIT
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Legal document waiving liability for minor participation in North American Roller Hockey Championships activities, acknowledging risks and parental consent.
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Notice Of Lawsuit And Request To Waive Service
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Legal document requesting defendant to waive formal service of lawsuit summons under Nevada Rules of Civil Procedure
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Waiver Of Medical Insurance Coverage
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A form for employees to waive medical insurance coverage while certifying alternative group medical insurance and applying premium sharing to optional coverage.
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SOUTHWEST TEXAS JUNIOR COLLEGE WAIVER OF LIABILITY MEDIA RELEASE FORM
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A document requiring parental consent for a STEM summer camp, including liability waiver and media release permissions.
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USACC Form COIRWL 1, V. 1.1
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A liability release form for participants in Army ROTC/JROTC military-style training activities, acknowledging voluntary participation in potentially risky events.
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Research And Academic Areas Use Assumption Of Risk And Release Of Liability For Volunteers And Visit
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A legal document for non-student and non-employee volunteers to assume risks and release the University of Michigan from liability when using university facilities.
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Waiver Of Medical Coverage Form
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Form for employees to waive State Employee Group Insurance Program (SEGIP) medical coverage when having alternative coverage.
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OnlineDistance Learning Students Refund Request Form
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Form for out-of-state online students to request waiver of certain campus fees for distance learning courses.
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Accident Waiver And Release Of Liability
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Legal document releasing Habitat for Humanity from liability for volunteer activities and potential risks during participation.
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Waiver Of Police Officer Training Requirement
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A form for police officers seeking certification of prior basic training or equivalency from the New York State Division of Criminal Justice Services.
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Parks And Recreation Department Waiver Release Form
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Legal document releasing the City of Miami Beach from liability for injuries or damages during recreational activities.
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GT Waiver Of Liability, Assumption Of Risk And Indemnity Agreement
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A comprehensive legal document outlining risks and liability for participants in athletic, recreational, and adventure programs at Georgia Tech.
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Waiver Authorizing Disclosure Of Information And Releasing Liability
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A legal document required by Wisconsin statute for law enforcement job candidates to authorize disclosure of employment files and release employers from liability during hiring process.
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CSD K 2 Waiver Form
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A form for parents to request a school transfer for kindergarten through 2nd grade students within the Colchester School District.
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Waiver Service Approval Form
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A form used by care coordinators to request and approve waiver services for members, documenting service details and provider information.
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Waiver Service Request Form
PDF template
Comprehensive form for requesting rehabilitation and support services with detailed client and medical information.
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Securing Waivers Of Liability From Volunteers Of Nonprofit Organizations
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A comprehensive guide for nonprofit organizations on obtaining and implementing volunteer liability waivers to protect the organization from potential legal claims.
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Assumption Of Risk, Accident Waiver And Release Of Liability
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Legal document that releases liability for participants in adaptive sports activities, acknowledging potential risks and waiving claims against event organizers and sponsors.
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Vaccine Administration Record (VAR)Informed Consent For Vaccination
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Legal consent form for vaccine administration, detailing patient rights, risks, and information sharing permissions.
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St. Clair County Community CollegeYMCA Of The Bluewater Area Activity Waiver Form
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A comprehensive waiver form for participants in college and YMCA activities, addressing risks, liability, and emergency treatment consent.
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Walking Field Trip Standing Consent Form
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A consent form allowing students to participate in walking field trips within a specified distance from their school for educational activities.
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Verbal Sign Out Feedback Form
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Structured evaluation form for assessing the quality of medical trainee verbal patient handoff communication during overnight transitions of care.
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Warfarin Care Hospital Discharge Form
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A specialized hospital discharge form for patients in the Warfarin Care program, tracking medication and health status upon patient release.
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PHOTO VIDEO RELEASE FORM
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A legal document granting Miami-Dade County permission to use an individual's image or recording for promotional purposes.
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Annex C Sample Sanitary Survey Form For Boreholes
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A comprehensive checklist for assessing potential contamination risks and water safety in borehole water sources.
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Claim Payment Appeal Submission Form
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A form for healthcare providers to submit appeals regarding claim payment decisions made by Amerigroup Washington, Inc.
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WASHINGTON YOUTH SOCCER PARENTGUARDIAN CONSENT AND PLAYER MEDICAL RELEASE FORM
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Medical release and consent form for youth soccer players, including emergency contact and medical history information.
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WBG Volunteer Time Card
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Volunteer time card and release form for Union Sportsmen's Alliance participants, including personal information and liability waiver.
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Inspection Consent Form
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A form allowing tenants to provide consent for rental property inspections in compliance with Minneapolis municipal code.
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Membership Form
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Comprehensive membership registration form for participation in Parks and Recreation Department programs, including personal and family details and liability waiver.
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WDA Checklist Form
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Guide for employment service providers to collect mandatory data categories for federal and provincial employment funding reporting requirements.
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MEDIA RELEASE FORM
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A legal document granting permission for an individual's image to be used in various media publications and platforms.
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Website And Social Media Release Form
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Legal authorization for Primary Pediatrics to use a child's photos or stories on their website and social media platforms.
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Weekly Disability Claim Form
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A comprehensive form for reporting employee disability claims, including sections for employee, employer, and physician statements.
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Weight Management (Semaglutide) Medical History Form
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A comprehensive medical history form for patients seeking weight management treatment using Semaglutide medication.
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Confidential Medical Form
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Medical form for Joy Outdoor Education Center's Camp WEKANDU, providing instructions for medication management and health requirements for campers.
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General Consent Form 2016 17
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Annual parent welcome letter from Alexander Academy providing school year information and required consent forms for students.
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Otolaryngology DIAMOND CONFERENCE Welcome Reception Registration
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Registration form for welcome reception at the Otolaryngology Diamond Conference with ticket pricing and payment options.
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Joint Welfare Fund LU 164 HRA Reimbursement Form
PDF template
Health Reimbursement Account (HRA) claim form for submitting medical expense reimbursement requests for members and dependents.
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WELL BEING ACTIVITY PROPOSAL FORM
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A form for proposing and obtaining approval for a well-being activity within an educational or medical organization.
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Well Being Index Academic License Agreement
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Legal agreement for academic users to utilize the Well-Being Index measurement tool for medical education and research purposes.
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Student Insurance Claim Form
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A comprehensive insurance claim form for students to report medical examinations, illnesses, injuries, and insurance coverage details.
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WELLNESS BENEFIT CLAIM FORM (Accident Insurance)
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A form for submitting wellness exam and preventive health screening claims under an accident insurance policy.
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Wellness Benefit Claim Form
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A claim form for submitting wellness-related medical tests and screenings for potential insurance benefits.
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RELEASE AND WAIVER OF LIABILITY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT AND DIGITAL, FILM, VIDEO
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Legal document releasing event organizers from liability and assuming risk for participation in an art event involving pets.
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What Is A Waiver And Consent Form
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A document explaining the purpose, importance, and key considerations of waiver and consent forms in various contexts, including research and medical settings.
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Underage Buyer Consent Form Sample
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A document providing consent for an underage individual to engage in a transaction or activity with parental or guardian permission.
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WIAA Physical Examination Form For Pius XI Catholic High School
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A mandatory medical examination form for students participating in interscholastic athletics, documenting physical fitness for sports participation.
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NEW JERSEY WIC HEALTH CARE REFERRAL
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A comprehensive health referral form for children under 5 years old, collecting medical and anthropometric data for WIC program enrollment.
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WIC Medical Referral Form For Infants And Children
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A medical referral form for collecting health and demographic information about infants and children for the WIC (Women, Infants, and Children) program.
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DOH 799 WIC Medical Referral Form
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A medical referral form used to refer patients to the WIC Program and communicate patient health information for nutrition care and counseling.
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Authorization For Use Disclosure Of Health Information
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A form authorizing the release of protected health information between specified individuals or organizations with patient consent.
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Naropa University Wilderness Therapy Confidential Medical Record
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Comprehensive medical intake form for Naropa University's Wilderness Therapy program, requiring detailed health information from prospective and current students.
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WILD GUYde Adventures MEDICAL HISTORY
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Medical history form and liability agreement for outdoor adventure activities with detailed health screening and participant acknowledgment of risks.
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Medical Form
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Comprehensive medical history form for participants in outdoor adventure activities, including health conditions, emergency contacts, and liability acknowledgment.
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Student Health Record
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Comprehensive medical history form for nursing students, collecting personal health information and health status details.
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WI MemberS Details And Data Protection Consent Form
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A form for WI members to provide personal details and consent to data usage and image sharing across various media platforms.
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WMBDC Photo Gallery Of Stars Contact Form
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Form for minority women-owned businesses to provide contact information and photo consent for Delta State University's Women Minority Business Development Center
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Imaging Outpatient Order Form
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Comprehensive medical imaging order form for capturing patient information and procedure details for various radiology examinations.
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MEDICAL RELEASE FORM
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A medical authorization form allowing treatment of a minor athlete in case of emergency when parent/guardian is unavailable.
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Medical Form
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A confidential medical form for students attending Westminster Choir College's Summer Arts Programs, collecting health and emergency contact information.
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OBSTETRICS AND GYNECOLOGY INTAKE FORM
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Comprehensive medical intake form for patients seeking obstetric and gynecological care, collecting detailed personal and medical history information.
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Liability Waiver Form
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A legal waiver releasing the Columbus Police Department from liability during a self-defense class participation, covering potential physical injury or property damage.
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MEDIA RELEASE FORM
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A form granting permission to Women Writing for (a) Change to use participant's visual or audio content for promotional purposes.
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Working Spouse Premium Waiver Form
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Form for Purdue employees to certify spouse's medical insurance eligibility and waive working spouse premium
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Participant Release Of Liability, Waiver Of Claims, Assumption Of Risks And Indemnity Agreement
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Legal document outlining risks and liability waivers for participants in river rafting activities with World Wide River Expeditions.
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Medical Release Form
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A legal document granting medical treatment permission for a minor by a parent or guardian, valid for one year.
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NFHS Medical Release Form For Wrestler To Participate With Skin Lesion(S)
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A medical release form developed by the National Federation of State High School Associations to guide participation of wrestlers with skin lesions while minimizing disease transmission risks.
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Medical Release Form For Wrestler To Participate With Skin Lesion
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A medical form documenting a wrestler's skin condition and clearance to participate in competitions.
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Publication, Video And Website Consent And Release Agreement
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A consent form allowing use of an individual's name, image, voice, and work for publicity and promotional purposes by Washington Service Corps and related organizations.
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SUBSTITUTIONEXCEPTIONWAIVER FORM (Undergraduate)
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A form for undergraduate engineering students to request course substitutions, exceptions, or policy waivers at Johns Hopkins University.
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West Side Soccer League Tryout Participation Waiver Medical
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Registration form for soccer players with medical information, emergency contacts, and parental consent for participation and media usage.
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Family Medical Leave Request Form
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Comprehensive form for employees to request family and medical leave, covering various types of leave and documentation requirements.
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Risk Assessment Form
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A comprehensive risk assessment document for a junior open water swimming session, identifying potential hazards and mitigation strategies.
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Veterinary Intake Form
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Comprehensive intake form for veterinary clinic appointments during COVID-19 pandemic, capturing pet and client medical information.
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Wildwood Veterinary Clinic Pet Intake Form
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A comprehensive veterinary intake form for documenting pet health history and current medical conditions during COVID-19 pandemic protocols.
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Medical History Form
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Comprehensive medical form for collecting patient's personal, surgical, and family medical history details.
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Alabama WISEWOMAN Data Collection Patient Intake Form
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Medical intake form for collecting patient personal information and health history in Alabama's WISEWOMAN program.
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Summer Camp Accident Waiver And Release Of Liability Form
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A liability waiver for parents allowing their children to participate in Washington Waldorf School's summer camp program, covering potential risks and medical authorization.
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Medical Release Form
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A medical release form allowing emergency medical treatment for a youth soccer player by parent or legal guardian.
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Parent Guardian Consent And Player Medical Release Form
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Medical consent and emergency information form for youth soccer player participation and medical authorization
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Physical Examination Form I
PDF template
Medical examination form for youth admission to Mississippi Department of Human Services youth development center
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XII 1 Workload Reduction Waiver Form
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Form allowing faculty to voluntarily teach more than standard course preparations without corresponding workload reduction.
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5.3S Hazard Report Form
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A form for documenting and reporting potential workplace hazards, risks, and safety concerns for employees, contractors, and visitors.
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Evaluation Form
PDF template
Form for evaluating the quality and completeness of medical sign-out procedures between healthcare providers.
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Form DI 4015 United States Youth Conservation Corps Medical History Form
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Medical history form for applicants to the U.S. Department of Interior's Youth Conservation Corps program to determine eligibility and health status.
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YEARLY UPDATE FORM YEAR 2023
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Annual form for updating patient and guardian information for established pediatric patients under 18 years old.
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Youth Empowerment Summit Application Packet
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Comprehensive application packet for youth summit participants including medical information, consent forms, and participant details
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Media Release Form
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A legal document granting the YMCA permission to use photographs, videos, and other media featuring participants in their programs.
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Guest Waiver Fitness Release
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Legal document releasing YMCA of the Chesapeake from liability for potential injuries during fitness activities and program participation.
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Permission SlipMedical Release Form
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Medical release and permission slip for Presbyterian Church youth mission trip to North Carolina, covering medical information and parental consent.
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YOGA CLASS WAIVER FORM
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Legal waiver form for participants in yoga classes, collecting personal and medical information and releasing liability.
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Musician Medical Form
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Medical form for musician participation in the Youth Orchestra of Palm Beach County, requiring health and emergency contact information.
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New Mexico 4 H Youth Medical And Liability Release Code Of Conduct Contract And Media Release Form
PDF template
A comprehensive form for 4-H youth participants covering medical information, liability release, code of conduct, and media release.
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Liability Release Form
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A comprehensive legal document releasing the church from liability and granting medical treatment authorization for participants in church activities or trips.
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Acknowledgment And Assumption Of Risks Release And Indemnity Agreement
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Legal document outlining risks and liability for youth participants in wilderness activities with Women's Wilderness Institute.
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Youth Media Release Form
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A legal document authorizing the Diocese to use images, videos, and recordings of an individual for media purposes.
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Medical Release Form
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A medical release and emergency contact form for children participating in Parks & Recreation programs, granting medical consent and providing critical health information.
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Medical ReleasePermission Form
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A comprehensive medical form for participant information, emergency contacts, medical details, and liability waiver for activities.
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Member Information Form
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Registration form for youth to join Boston Centers for Youth & Families community programs, collecting personal and medical information.
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Facility Risk Assessment Form
PDF template
A comprehensive assessment form for identifying facility risks and safety considerations for youth programs.
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Youth WaiverService Learning Waiver
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Waiver form for youth participation in forest restoration and volunteer programs, including photo/media release consent
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Clinic Visit Parental Consent Form
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A consent form for pediatric clinic visits, collecting patient and parent/guardian information and communication preferences.
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Client Referral Form
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A comprehensive form for referring a client for healthcare or therapeutic services, capturing personal, medical, and contact information.
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COVID 19 Testing Registration Form
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A registration form for SARS-CoV-2 nucleic acid testing with patient demographic and insurance information.
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LifeVest Medical Order Form
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A medical order form for prescribing and configuring a LifeVest wearable cardioverter defibrillator for patients at risk of cardiac events.
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