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Thank You

Thank you for your request.
We will contact you within the next 4 buisness hours about your request.
When we call we will look to collect the following additional information to complete your request.

• Insurance ID (s)
• Physician Information
• Your Diagnosis
• Delivery Inforamtion

We will also review your product choices and answer any questions you may have.
Thank you,
Active Life Medical

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