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Form 4DONOR SELECTION FORM Referring Physician: Referring Physician City, State: Referring Physician Phone Number: (Patient name: Partner name: Address: Phone: Donors selected: 1.)) DOB: DOB:2.) Patient
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The donor selection form is a document used to specify and record the choice of individuals or organizations that will donate funds or resources for a particular cause or project.
Any individual or organization that is receiving donations and wishes to specify the sources of those donations may be required to file a donor selection form.
The donor selection form can typically be filled out by providing the names and contact information of the donors, as well as details about the amount or nature of the donations.
The purpose of the donor selection form is to ensure transparency and accountability in the donation process, by documenting the sources of funds or resources for a specific cause or project.
The donor selection form may require reporting of donor names, contact information, donation amounts or descriptions, and any other relevant details about the donors and donations.
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