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Taro Health and Fulcrum 2024 Interest Form
Please answer the following questions to add yourself to our list of patients with Taro Health for 2024
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* Indicates required question
Are you already enrolled in Taro Health for 2024?
*
Yes
No
What is you first name?
*
Your answer
What is your last name?
*
Your answer
What is your phone number?
*
Your answer
What is your email?
*
Your answer
Which physician were you hoping to join with?
*
Dr. Rulf
Dr. Lucas
Did you already have a meet and greet with this physician?
*
Yes
No
I am scheduled in the near future
Please contact me to help schedule a meet and greet.
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