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Form F800-058-000 Crime Victims Statement for Pharmacy Services - Washington
What Is Form F800-058-000?
This is a legal form that was released by the Washington State Department of Labor and Industries - 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 the F800-058-000 form?
A: The F800-058-000 form is the Crime Victims Statement for Pharmacy Services in Washington state.
Q: Who is required to fill out this form?
A: Pharmacies in Washington state are required to fill out this form when providing services to crime victims.
Q: What is the purpose of this form?
A: The form is used to document the services provided by pharmacies to crime victims for reimbursement purposes.
Q: Do I need to include any supporting documentation with the form?
A: Yes, you should include copies of the pharmacy receipts and any other relevant documents along with the form.
Form Details:
- Released on September 1, 2013;
- The latest edition provided by the Washington State Department of Labor and Industries;
- 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 Form F800-058-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.
Download Form F800-058-000 Crime Victims Statement for Pharmacy Services - Washington
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