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Appendix A Mass Prophylaxis Screening Form NAME ? ADDRESS ? PHONE ? HEALTH HISTORY Sections I thru IV ? To be completed by individual obtaining medications Date: I. Site: City: County: INFORMATION

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What is naph form pdf?

The NAPH form pdf stands for Non-Accidental Personal Health Insurance form in PDF format. It is a document used for reporting personal health insurance coverage.

Who is required to file naph form pdf?

Individuals who have personal health insurance coverage are required to file the NAPH form pdf.

How to fill out naph form pdf?

To fill out the NAPH form pdf, you need to provide accurate information about your personal health insurance coverage. This includes details such as the policy number, insurance provider, coverage start and end dates, and any dependent information.

What is the purpose of naph form pdf?

The purpose of the NAPH form pdf is to report personal health insurance coverage and ensure compliance with relevant regulations.

What information must be reported on naph form pdf?

The NAPH form pdf requires the reporting of details such as the policy number, insurance provider, coverage start and end dates, and any dependent information related to personal health insurance coverage.

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