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iCare Suggestion Box

Our goal is to provide Extreme patient-centered care and we value your suggestions about our services,
Suggestion:

Should you want us to follow-up with you on your suggestion(s)‚ we ask that you provide the following information.
Your Name:
Your Email Address:
Telephone Number:
 

Thank you for your feedback! We appreciate your time and effort in filling out this form.
Last Updated: 6/17/14