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One more step, [user_firstname]!

Important information on your next step is below. You are not done yet! We’re getting ready to process your order, but we need you to do one more thing before we can finalize it. We need your medical history!

Your physician will review your medical history and will contact you.

Fill out the information below to complete your medical history. If you have any questions, please contact us and reference your order number.

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