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Agreements and Forms
Agreements and Forms
Agreements & Forms
Electronic Funds Transfer (EFT) Agreement 08/1/19
Participation and Payment Agreement
Preceptor/Protocol Agreement Form January 2017
Trading Partner Agreement Enrollment Form 1/1/14
Instructions for Providers 01/1/14
Instructions for Vendors and Clearinghouses 01/1/14
Trading Partner Agreement 07/19/13
Disclosure of Ownership and Control Interest Statement SCDHHS Form 1514
Trading Partner Agreement Enrollment Form for Vendors and Clearinghouses
