medical confirmation form definition

medical confirmation form means a written form issued by a retailer or network provider:
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medical confirmation form means a written form issued by us to enable you to provide Medical Confirmation to Us.
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Related to medical confirmation form

  • Tax Certification Forms means any forms or other documentation as may be issued or required by a Tax Authority or by us from time to time to confirm your tax status [or the tax status of a Connected Person].

  • Database application form means the application form required by the Hibiscus Coast Municipality to be filled in by the successful tenderer, following the award of the contract, for inclusion on the HCM database before payment is made.

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Bid Declaration Form means a declaration by the Bidders in form as specified in Annexure III of this E-Auction Process Information Document;

  • Application Form means any application form to be completed by subscribers for Shares as prescribed by the Company from time to time.