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Get CO CDPHE MMR1001 2014-2024

Ary. The date of your signature and the notary’s signature must be the same. j. The form cannot be notarized by the patient, the caregiver, the physician or the person who signs the payment. 2. Physician Certification a. Your physician must complete, sign, and date the physician certification. b. The signing physician must be an MD or DO with an active Colorado medical license. Physicians with conditions or restrictions on their licenses, or out-of-state licenses, are not accepted. c. The Regi.

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