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Exception Request/Process

Document Number:  DVR-14918-E

Description:  This form is used to request, review and document approval of purchases of goods and services that exceed the fee schedule prices or scope of services, established policy and/or procedure.

Comments:  Form is protected from modification and enabled for form fill (includes tabbed fields for form completion).  The print (pdf) version is available for viewing and printing only.

Content Contact:  DVR Forms

Document Attachments:

DVR-14918-E  (Electronic Version - Word/29 KB)

DVR-14918  (Print Version - pdf/82 KB)

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