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Prior Authorization Form/ Prescription Date: Date Medication Required: Ship to: Physician Patients Home Other Phone: (866) 399 0928 Fax: (855) 678 6976 Patient Information Last Name: First Name: Middle:
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What is growth failure?
Growth failure is a condition in which a child does not grow at the expected rate for their age.
Who is required to file growth failure?
Healthcare providers or medical professionals are required to file growth failure.
How to fill out growth failure?
To fill out growth failure, healthcare providers need to accurately record the child's growth measurements and any relevant health information.
What is the purpose of growth failure?
The purpose of growth failure reporting is to track and monitor children's growth patterns to identify potential health issues or delays.
What information must be reported on growth failure?
Information such as the child's height, weight, age, and any relevant health conditions must be reported on growth failure.
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