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Dartmouth Hitchcock (DH) and the Gases School of Medicine at Dartmouth (Gases) Financial Disclosure Mitigation Form 1)Name of Person with COI (please print):2)Name of Activity:3)Date(s) of Activity:FINANCIAL
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Mitigation form is a document used to request a reduction or elimination of a penalty or fine.
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Any individual or organization that wants to appeal or reduce a penalty is required to file a mitigation form.
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