Funds Use Verification Form: Logo
  • Funds Verification Form:

    Please note: the information provided on this form is what TCWD will use as the guidelines for how the awarded incentive funds need to be spent- this information should be accurate to the best of your knowledge. Any changes to this information need to be communicated to TCWD asap.
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  • TCWD will review this document as soon as possible. TCWD will need to provide approval of this form before incentive funds are sent to the practice site. The practice site cannot start using the funds until TCWD has provided approval for appropriate use of funds. 

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