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Menu
  • Home
    • Dental
    • Gynaecology / Pregnancy
    • Dermatology Skin Care
    • Psychiatry
    • General Practitioner
    • General Practitioner 2
  • Our Practice
    • Rejoignez-nous
    • Testimonials & Reviews
    • Schedule
    • Blog
  • Get Care
    • Get Care
    • Urgent Care
    • Primary Care
    • Lab Tests
    • Annual Wellness Exam
    • Pediatric Care
    • Virtual Care
  • Providers
  • Patients Info
    • Billing & Insurance
    • Contact & Location
Urgent Care 24h

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+ 1 541-754-3010

Online Forms

Request Appointment >
+ 1 541-754-3010

Online Forms

Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider.

  • Screening Checklist for Visitors
  • New Patient Enrollment Form
  • Medical History Form
  • Online Doctor Appointment Form
  • Psychiatric Evaluation Form
  • Quick Emergency Contact Form
  • Blood Donation Form
  • HIPAA Privacy Restriction Questionnaire
  • Medical Release Form

Le Club Poussette est une association qui vit grâce à vos dons et adhésions.

 

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Contact >

Adresse :

8 Rue Albert Samain
75017 Paris

Téléphone : 0757434255

Mail: leclubpoussette@gmail.com

 

 

Address:  

Boston, USA
55 Huntington Ave Ste

 

Phone:

+1 541-754-3010

 

Opening Hours:

Mo-Fr: 07:00-23:00h

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+ 1 541-754-3010

Use only for Stomach pain, Trauma,
Headache, Bike accidents etc…

 

For more serious problems 
please call 911.

Boston, USA 55 Huntington Ave Ste

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