39 id me labels coupon code
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services.gileadhiv.com › content › pdfPATIENT ENROLLMENT FORMTO BE COMPLETED BY THE PATIENT OR ... residency. Patient photo ID may be required. ━ Check the appropriate box, sign, and date if you would like to have the prescription shipped directly to the prescriber’s office/ clinic and/or if you are applying to the PAP/MAP. ⊲ SECTION 6 (REQUIRED) The patient (or the patient’s representative) must sign and date this section.
Id me labels coupon code
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