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DOH Form 348-243 Provider Disenrollment Form - Childhood Vaccine Program - Washington
What Is DOH Form 348-243?
This is a legal form that was released by the Washington State Department of Health - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DOH Form 348-243?A: DOH Form 348-243 is the Provider Disenrollment Form for the Childhood Vaccine Program in Washington.
Q: What is the purpose of the Provider Disenrollment Form?A: The Provider Disenrollment Form is used to discontinue participation in the Childhood Vaccine Program in Washington.
Q: Who is required to submit the Provider Disenrollment Form?A: Providers who wish to discontinue participation in the Childhood Vaccine Program in Washington are required to submit the Provider Disenrollment Form.
Q: What program does the Provider Disenrollment Form relate to?A: The Provider Disenrollment Form is specifically for the Childhood Vaccine Program in Washington.
Form Details:
- Released on October 1, 2021;
- The latest edition provided by the Washington State Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of DOH Form 348-243 by clicking the link below or browse more documents and templates provided by the Washington State Department of Health.
Download DOH Form 348-243 Provider Disenrollment Form - Childhood Vaccine Program - Washington
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