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Get Health Systems Quality Assurance - Washington State Department...

Signature lines. Prescriber s Name Clinic Name (if applicable) Practice Site Address Phone Number Substitution Permitted Dispense as Written We ve listed below items that must appear on a prescription form. Washington laws or rules do not define the format or size of a prescription. Therefore, you may continue to use the same prescription formats or layouts as you have in the past, so long as you position the seal and the two signa.

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