RAMQ Rx Payment Authorization – form 3996

RAMQ Rx Payment Authorization - form 3996

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This is the RAMQ Medication Payment Authorization form, available at https://www.ramq.gouv.qc.ca/sitecollectiondocuments/professionnels/formulaires/3996.pdf

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RAMQ-RxPaymentAuth-3996.zipDownload
RAMQ Rx Payment Authorization - form 3996
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