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BC Smoking Cessation Program Declaration and Notification

BC Smoking Cessation Program Declaration and Notification

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BC SMOKING CESSATION PROGRAM DECLARATION AND NOTIFICATION. This form must be completed each time a patient is dispensed a nicotine replacement therapy (NRT) product through the BC Smoking Cessation Program. Name of Patient. Date of Birth (DD/MM/YYYY) Personal Health Number (BC Services Card)

  Time, Smoking

Download BC Smoking Cessation Program Declaration and Notification


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