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Referral Cards Request Form

Registered providers can request complementary referral cards below

Referral cards provide the patient with everything needed to order their collection kits and can be provided during an on-site office visit. Simply provide your provider ID# and let us know where to send your cards.

  • Where should we send tracking information?
  • What address should we mail referral cards to?
  • This field is for validation purposes and should be left unchanged.
Contact: Salimetrics (USA)
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