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PLEASE NOTE This Signature Form must be accompanied by a fully-completed Provider Information Form. SOONERCARE PROVIDER AGREEMENT NEW PROVIDER SIGNATURE FORM Agreement Name s and Number s General Agreement 2009-2 Special Provisions appropriate to PROVIDER s Type If PROVIDER is an individual person the undersigned PROVIDER agrees to all terms and conditions of the SoonerCare Agreement and Special Provisions listed above. No person who has been inv...
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Please note this signature is a statement indicating that the signer acknowledges and agrees to the contents of a document or contract.
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The person or entity signing the document or contract is typically required to provide the please note this signature.
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To fill out the please note this signature, the person signing the document should write their name or initials, followed by the words 'please note this signature', indicating their acknowledgment and agreement.
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