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D 12 months. Routine breast and /or cervical re-screening should be performed through the BCCCP provider. BCCCP Coordinator: By checking ( ) YES you are verifying patient eligibility for BCCM Yes This patient is enrolled in the NC Breast and Cancer Control Program (BCCCP), and has received screening and/or diagnostic testing per the BCCCP guidelines. (A by YES requires this form be completed by the diagnosing or treating physician.) Name of Medical Clinic responsible for diagnosis and.
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