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Formulary Exception/Prior Authorization Request Form
Patient InformationPrescriber InformationPatient Name:Prescriber Name:Patient ID#:
Address:Address:City:
Home Phone:Gender’M or City:
Office
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What is supply?
Supply refers to the process of providing goods or services.
Who is required to file supply?
Any individual or business that sells goods or services is required to file supply.
How to fill out supply?
Supply can be filled out online or through manual forms provided by the tax authorities.
What is the purpose of supply?
The purpose of supply is to report the sale of goods or services and calculate the applicable taxes.
What information must be reported on supply?
Information such as the name of the supplier, the date of the transaction, the description of the goods or services, and the total amount charged must be reported on supply.
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