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Thank you for completing the Authorization for Release of Information (ROI). Your submission has been received.
ATTENTION: You will need to complete a separate ROI for each different clinic/location where you have received treatment for your current condition. If you need to fill out another ROI, go back and click the link in your original text message or email.
If you would like a copy of your completed paperwork, please contact us and request one:
- 952-841-2345
- referrals@tcpain.com
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