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Dme order form template

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The client parent or the guardian of the client and/or caregiver of the client has received training and instruction regarding the ________________________________________ Printed name of DME Supplier Signature of DME Supplier Signature of Client Parent Guardian or Primary Caregiver Section D Optional Certification Spanish Esto certifica que el mes/d a/a o _________________________ el cliente recibi el la los las satisface las necesidades del cliente. El cliente padr ...

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