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Current Provider Information

This page provides important information for current Take Charge! providers. This page provides the guidelines for breast and cervical cancer screening, available forms, and current listing of all Take Charge! Contractors.  

Clinical Guidelines and Orders

Breast Cancer Screening Guidelines and Orders
Cervical Cytology Guidelines and Orders
Dysplasia Guidelines and Orders

Guidelines for Take Charge! Funded Services

Breast Diagnostic 
Surgical Consult

Available Forms

274 Form Instructions
274 Form (Pap Smear Requisition)

274A Form Instructions
274A Form

274CD Form Instructions
274CD Form

833 Form Instructions
833 Form 

FY13 Invoice Template

Supply Order Form

Contracted Facilities

All Take Charge! Contracted Facilities


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