NNERNA Insurance Verification Request
Please complete the following when a facility hosting an NA event or meeting is requesting proof of regional insurance.
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Is this request for a group or event?
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Name of Group/ Event
Location (Please include facility name and street address including ZIP code.)
Group meeting day(s) and time or event date(s) and time
Group contact name
Group contact email
Facility contact name
Facility contact email or fax
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