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Please note: If this is your first prescription or referral order this quarter, you will need to come to our practice in person so that we can scan your health insurance card.
Transfers can be collected after 2 working days during office hours.
Please understand that if you enter incorrect information, if we cannot clearly assign it to you, or if you are not registered with us as a patient and receiving treatment, your request will not be processed.
Please note that while messages sent via this form are transmitted in encrypted form, we cannot absolutely rule out the possibility that third parties might gain access to the data.
Here you can find our privacy policy .
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