Screen Two: Program Legal Agreement

 Purpose

 Online Form


Field Name

Description

Pressing Accept will take you to screen three of the enrollment process: Providers within the Practice that Administer Vaccines.

NOTE: Public Health Departments are not required to fill out Providers within the Practice and will advance to the Provider Estimates form.

Pressing Previous will take you back to screen one of the enrollment process.

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 Notes

    

 

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