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He user name using the first two initials of the first name and then the last name. If applicable, specify existing user profile to model new user after. Also indicate if prescribing RX RIGHTS, NOTE ownership, SCAN login, DLC (Download chart) to PDF, and ability to UNLOCK notes is required. List any users whose TW access needs to be disabled in the lower section. Practice/Group Name: Name (Last, First): (Please call to request new provider set up. Additional information is required.) Users to.
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