{"data":{"id":"us-in/ic-16-41-19-4","jurisdiction":"us-in","citation":"IC 16-41-19-4","heading":"Affirmation","body":"Sec. 4. The physician or advanced practice registered nurse applying for free biologicals as provided in this chapter and IC 12-20-16-14 shall sign in ink the following affirmation printed on the application form:\nI solemnly affirm that the free biologicals applied for will be administered to the person named above, and it is my belief after inquiry that the person is financially unable to pay for the biologicals.","path":["TITLE 16. HEALTH","ARTICLE 41. PUBLIC HEALTH MEASURES FOR THE PREVENTION AND CONTROL OF DISEASE","Chapter 19. Prevention and Treatment Programs: Provision of Free Drugs and Vaccines to Indigents"],"source_url":"https://iga.in.gov/ic/2026/Title_16.html#16-41-19-4","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-11T20:02:18Z","sha256":"4b6b0bf3ca90ec1b2910062f2494d4d68280abfe10f175ac3c85e2889b2044a3","source_id":"us-in","stale":false,"prev":"us-in/ic-16-41-19-3","next":"us-in/ic-16-41-19-5"},"notice":"GroundRules: Original legal text. Not legal advice."}