C-8 Medical Monitoring Program

Registration and Eligibility Form

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If you use the option below ‘Download and Print Registration and Eligibility Form’ you may print the blank document to be completed by hand, or type the information on the PDF itself. In either case, the completed document must be mailed back to the Administrator at:

C-8 (PFOA) Medical Monitoring Program
c/o GCG
PO Box 10030
Dublin, Ohio 43017-6630