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Get the free WI16 Self Pay Enrollment form - University of California - ctri ucsd

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CREST Program COURSE ENROLLMENT AND SELF PAYERS FORM QUARTER: WINTER 2016 UCSD residents, fellows (including laboratory based fellows×, faculty, and staff pay a discounted fee. The fee covers the
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WI16 self pay enrollment is a form that individuals can use to enroll in a self-pay program for healthcare services.
Individuals who are self-paying for healthcare services are required to file WI16 self pay enrollment.
WI16 self pay enrollment can be completed by providing personal information, details of the healthcare services being paid for, and signing the form.
The purpose of WI16 self pay enrollment is to enroll individuals in a self-pay program for healthcare services.
Information such as personal details, healthcare services being paid for, and signature must be reported on WI16 self pay enrollment.
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