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Please note, this form should not be used for sending medical information. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room. Your information will be sent to our administrative staff during standard office hours, and then forwarded to your provider. We strive to return calls or messages as quickly as possible, but please allow up to 48 hours for a response to your message. Please include your date of birth, provider, and the best number to contact you.