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Complete this form to prevent sharing of the immunization record from LINKS with authorized users other than the primary care provider or local health unit. Please print. I ___/___wish to prevent
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What is complete this form to?
This form is completed to provide necessary information.
Who is required to file complete this form to?
Individuals or entities who meet certain criteria are required to file this form.
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Fill out the form accurately and completely according to the instructions provided.
What is the purpose of complete this form to?
The purpose of this form is to gather specific information for reporting purposes.
What information must be reported on complete this form to?
Information such as income, expenses, and other relevant data must be reported on this form.
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