Application forms

Ind. Code § 16-41-19-3, under Chapter 19. Prevention and Treatment Programs: Provision of Free Drugs and Vaccines to Indigents.

Ind. Code § 16-41-19-3

Sec. 3. The state department shall supply the necessary application forms to all local health officers for the administration of section 2 of this chapter and IC 12-20-16-14. The local health officers shall supply physicians with the forms on request. The application forms shall be designed to provide the statistical information required by the state department. [Pre-1993 Recodification Citation: 16-1-14-3.] As added by P.L.2-1993, SEC.24.