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280 Agenda Jesus T. Piero, Suite B Rio Piers, PR 00927 ? Enrollment Form Fax Referral To: 888-280-1191 Toll Free Phone: 888-280-1190 Ship to: Patient Office Date: Local Phone: 787-759-4162 Local Fax:
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How to fill out a fax referral to 888-280-1191:

01
Start by gathering all the necessary information you will need to fill out the referral form. This may include the recipient's name, contact information, and any specific details or instructions.
02
Ensure that you have a valid fax number to send the referral to. In this case, the fax number is 888-280-1191.
03
Prepare a cover sheet for the fax referral. The cover sheet should include your own contact information, the recipient's contact information, and any additional details or notes that may be relevant.
04
Fill out the referral form, providing accurate and complete information. Be sure to include any required details or documentation that may be necessary for the referral.
05
Double-check all the information you have entered to avoid any errors or omissions. It is crucial to ensure the accuracy of the referral form before sending.
06
Once you are confident that the referral form is accurately filled out, send it via fax to the number 888-280-1191. Make sure that the fax is transmitted successfully.

Who needs fax referral to 888-280-1191:

01
Individuals or organizations who want to refer someone or send important documentation to the recipient specified by the fax number 888-280-1191.
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Those who need to send confidential information securely and quickly to the recipient.
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People or entities who prefer to use traditional faxing methods for communication purposes.
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