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Huntington's disease MEDICATIONS (FOR REQUEST) New Hampshire AIDS Drug Assistance Program Prior Authorization Request Form Fax: 18004247984 Phone: 18004247901 Date of Medication Request: / / Section
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This document is a form used for reporting hunting-related diseases to the relevant authorities.
Hunters, hunting organizations, and healthcare providers are required to file this form.
The form must be filled out accurately with all relevant information regarding the hunting-related disease.
The purpose of this form is to track and monitor hunting-related diseases for public health and safety.
Information such as the type of disease, affected individuals, location of the outbreak, and any relevant medical history must be reported on the form.
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