Medical Forms Documents
Medical Forms
TSP-77 Partial Withdrawal Request for Separated Employees
The TSP-77 form is used by separated employees to request a partial withdrawal from their Thrift Savings Plan account. It includes instructions for completing the form, certification, and notarization requirements. The form must be filled out completely and submitted along with necessary supporting documents.
Medical Forms
Ray's Food Place Donation Request Form Details
This file contains the donation request form for Ray's Food Place. Complete the general information section and follow the guidelines to submit your donation request at least 30 days in advance. The form includes fields for organization details and donation specifics.
Medical Forms
Common Law Marriage Declaration Form for FEHB Program
This form is used to declare a common law marriage for the purpose of enrolling a spouse under the Federal Employees Health Benefits (FEHB) Program. It requires personal details, marriage information, and additional documentation. Submission instructions and legal implications are included.
Medical Forms
Texas Automobile Club Agent Application Form
This file is the Texas Automobile Club Agent Application or Renewal form, which must be submitted within 30 days after hiring an agent. The form includes fields for agent identification, moral character information, and requires signature from both the agent and an authorized representative of the automobile club. Filing fees and submission instructions are also provided.
Medical Forms
Sterile Dressings for Wound Care
This file provides detailed information about Xeroform and oil emulsion dressings used for various types of wounds. It includes product descriptions, indications for use, and information on sizes and quantities. Essential for medical professionals dealing with wound care.
Medical Forms
CERTIFICATION OF MISSING OR LOST RECEIPT Form
This file is a Certification of Missing or Lost Receipt form that must be completed when the original receipts for expenses are not available. It outlines the necessary expenses which can be claimed, and describes the process for certifying those expenses. Complete this form to ensure compliance with travel regulations.
Medical Forms
Ohio Civil Service Application Form for State Agencies
This is the Ohio Civil Service Application form for state and county agencies. It contains sections for personal information, education, employment history, and certifications. Ensure all information is filled out accurately to be considered for state employment.
Medical Forms
Driving Record Request Form - Massachusetts RMV
This form allows individuals to request their driving records from the Massachusetts Registry of Motor Vehicles. It can be used for personal reference or to authorize the release of driving records to another person. Complete the form and follow submission instructions.
Medical Forms
Home Phototherapy Order Packet and Instructions
This file contains instructions and forms required for ordering Daavlin's home phototherapy devices. It includes detailed steps for patients and prescribers. Contact information and important procedures are also provided.
Medical Forms
NYC Police Department Applicant Employment Record Request
This file is a request form for the applicant's employment record required by the New York City Police Department License Division. It is used for investigating the character and record of a handgun license applicant. The form includes fields for the applicant's personal information and authorized consent for release of employment records.
Medical Forms
Pennsylvania Instant Check System Challenge Form
This document provides information and instructions on how to challenge a decision made by the Pennsylvania Instant Check System (PICS) concerning a background check. This form must be filled out and submitted within 30 days of a denial. Additional information to expedite the processing is encouraged.
Medical Forms
New York DMV Notice of Lien Form
This file is a Notice of Lien form from the New York State Department of Motor Vehicles. It is used to record a lien on a vehicle, boat, trailer, or manufactured home. The form needs to be filled out and submitted with relevant details.