Multiple Benzodiazepine Prescriptions Form

Office of the Deputy Secretary for Administration

This government document is issued by Office of the Deputy Secretary for Administration for use in Pennsylvania

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File Details: PDF (137 KB)
Downloads: 13
Source
https://www.dhs.pa.gov/providers/Pharmacy-Services/Documents/Fax%20Forms%20Non-PDL/Multiple%20Benzodiazepine%20Rxs%20PEAP%20form%2011-12-15.pdf

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