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After We Confirm Your Information, We Will Contact You Quickly To Provide Links For The Commercials You Are Interested In.
This form is required so we can verify that you are, in fact, a doctor or owner. And, that you are the decision maker in this clinic.
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After you submit your information above, we will reach out to you as quickly as we can to let you know if your territory is still available.
And, if your office qualifies.
You will also receive links to see examples of our commercials.
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