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Lupus Aware Physician List
Do you know of a physician who should be added to our list? If so, please complete this form.
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Physician's First and Last Name
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Practice Type:
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Rheumatologist
Cardiologist
Dentist
Dermatologist
Mental Health Professional
Nephrologist
Neurologist
ObGyn
Primary Care
Gastroenterologist
Other
Practice Name:
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Office Manager:
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Office Address:
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City:
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County:
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Office Email:
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Office Phone:
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Recommended by:
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Your Email:
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Insurance Accepted:
Cash Pay
Medicaid
Medicare
Private
Other:
What is your connection to lupus?
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I have lupus
My loved one has lupus
I am a healthcare professional
Other:
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Please provide any additional information:
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