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To Refer a Patient:
Send us a face sheet or demographics sheet of the patient to:
​​​​
Email: info@proactivehealth.tech
or
Fax: 888-823-5887
​
Required Information:
-
Name
-
DOB
-
Insurance Number
-
Phone Number
-
Diagnoses​​
Optional
Information:
-
​​Address
-
Medication List
If you do not have a face sheet​​
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