
Get the free Prairie View A&M University Youth Program Medical Treatment Authorization Form
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This Notice takes effect April 14 2003 and will remain in effect until we replace it. https //www. pvamu. I understand that PVAMU OwensFranklin Health Center does charge for services and that it is my responsibility to pay the bill if a claim can t be submitted by the PVAMU OwensFranklin Health Center to my private insurance. Personal Information Child s Last Name Specify program your child will be attending Address Home Phone First Name Birthdate City E-mail Address State M F Zip...
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Prairie View A&M University is a historically black university located in Prairie View, Texas.
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