ABBVIE IBD SCHOLARSHIP PROOF OF DIAGNOSIS FORM 2017 - crohnsandcolitis-2025

1. Click ‘Get Form’ to open the ABBVIE IBD SCHOLARSHIP PROOF OF DIAGNOSIS FORM 2017 in the editor.
2. Begin by entering your name in the 'Applicant Name' field. This identifies you as the scholarship applicant.
3. Fill in the 'Health Care Provider Name' and 'Hospital or Clinic Name' fields to provide details about your medical provider.
4. Complete the address section, including 'Street Address', 'City', 'Prov', and 'Postal Code' for accurate contact information.
5. Input the office telephone number and health care provider's email to facilitate communication regarding your application.
6. In the section for Health Care Provider, ensure they summarize your medical history related to inflammatory bowel disease accurately.
7. The health care provider must select the appropriate diagnosis (Crohn’s disease, Ulcerative colitis, or another form) and sign with their credentials.

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