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Name of Patient DOB Today's date Name of person completing form Relationship to Pt Pharmacy Not including use before exercise, how many times a week (on average) does your child use a rescue inhaler?
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To fill out the name of the person completing, follow these steps:
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Locate the designated space or field for the name of the person completing.
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Write down the full name of the person who is completing the form.
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The name of the person completing refers to the individual who is filling out the form or document.
The person who is responsible for completing the form or document is required to fill out the name of the person completing section.
To fill out the name of the person completing section, simply write the full name of the individual who is completing the form or document.
The purpose of the name of person completing section is to provide clarity on who completed the form or document for future reference.
The name of the person completing section typically requires the full name of the individual completing the form or document.
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