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Expiry Date: CVC #: Cardholders#39’s Signature: Email: I hereby authorize the use of this credit card for payment of services related to this order form. OPTION #1.
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What is esi toronto b2016b nalsi-order-bformb?
esi toronto b2016b nalsi-order-bformb is a form used to file naloxone orders in Toronto during the year 2016.
Who is required to file esi toronto b2016b nalsi-order-bformb?
Pharmacies and healthcare facilities that dispense naloxone in Toronto during 2016 are required to file esi toronto b2016b nalsi-order-bformb.
How to fill out esi toronto b2016b nalsi-order-bformb?
To fill out esi toronto b2016b nalsi-order-bformb, you need to provide information about the naloxone orders dispensed in Toronto during the year 2016.
What is the purpose of esi toronto b2016b nalsi-order-bformb?
The purpose of esi toronto b2016b nalsi-order-bformb is to track and monitor the distribution of naloxone in Toronto in 2016.
What information must be reported on esi toronto b2016b nalsi-order-bformb?
Information such as the quantity of naloxone dispensed, the dates of dispensing, and the recipient of the naloxone must be reported on esi toronto b2016b nalsi-order-bformb.
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