Tobacco Cessation Extension Form

Bureau for Medical Services

This government document is issued by Bureau for Medical Services for use in West Virginia

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File Details: PDF (193 KB)
Source
https://www.google.com/url?client=internal-element-cse&cx=007317577438028001491:f-xcusnnokg&q=https://dhhr.wv.gov/bms/BMS%2520Pharmacy/Documents/Pharmacy%2520Forms/Tobacco%2520Cessation%2520Extension.pdf&sa=U&ved=2ahUKEwjj0pr6xNmMAxUhT0EAHXHVDN84MhAWegQIBhAB&usg=AOvVaw1mpznnGqbbBGfHP4BSjtka

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