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Please get your weight, temperature, and blood pressure prior to your scheduled phone appointment. Enter the results below or indicate that you were unable to (for example, if you do not have a blood pressure cuff). Thank you!

How do you choose to identify and what are your choice pronouns, if any?

Please submit your credit card information for your co-pay, which will be charged on the day of your appointment. If you do not have a co-pay, scroll to the end of this form and click "SUBMIT FORM"

Type your name below to authorize Progressive Medical Associates to charge the credit card above for your co-pay. Thank you!

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