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04/23/14 Prior Authorization DELAWARE PHYSICIANS CARE (DE88) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date. Fax signed
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Next, fill out the "Reference Number" field if applicable.
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Enter the period for which the tax return is being filed in the "Period" section.
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Attach any supporting documents required for the specific tax return, if applicable.
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