Get Your Practice Listed

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Client ID Number (required)

Practice Name (required)

Provider Name (required)

Phone

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Comments

BioReference Laboratories, Inc. and its GenPath Diagnostics division, offers a physician locater tool on its 4Kscore website: www.4Kscore.com. This consent form serves as written confirmation of your agreement to have your contact information (e.g., name, address, telephone number, email) listed on the website as a healthcare provider who prescribes 4Kscore. By signing this consent form, you acknowledge that the public will be able to locate your contact information based on a geographic search tool, and that you may be contacted regarding 4Kscore. You may rescind this consent at any time by sending an email to physicianlocator@bioreference.com. Your information will be removed from the website listing within 10 business days.

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