Patient Forms

/Patient Forms
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Use this patient form to register for our upcoming clinics. Fill it out and send it with your payment to the address at the top of the form. If you have any questions, want to receive more information on our clinics, or want to learn more about what we do at ICBR, our contact information can be found under the “Contact Us” header. Call, write, or visit our Facebook page to learn more.

Patient Forms

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