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Authorization for Services

Document Number:  DVR-12785

Description:  This form is used for authorizing DVR services (paper version of an IRIS Purchase Order).

Comments:  The print version of the form is published for reference purposes. This form is automated in the DVR case management system and the customizable sections are completed via automated entry.

Content Contact:  DVR Forms

Document Attachment:  DVR-12785 (Print Version - pdf/117 KB)

Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.