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Trust mark Insurance Company Medical Questionnaire PO Box 7930, Lake Forest, IL. 60045 Phone (800) 2294543 x3413 Fax (847) 6154954 Cancer Questionnaire Proposed Insured: Birthdate: Address: Employee:

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What is 6x6cancerdoc?

6x6cancerdoc is a form used for reporting cancer-related data to the appropriate authorities.

Who is required to file 6x6cancerdoc?

Healthcare providers and facilities are required to file 6x6cancerdoc.

How to fill out 6x6cancerdoc?

6x6cancerdoc can be filled out electronically or manually, following the instructions provided by the relevant health authority.

What is the purpose of 6x6cancerdoc?

The purpose of 6x6cancerdoc is to collect and analyze data on cancer cases for research and public health purposes.

What information must be reported on 6x6cancerdoc?

6x6cancerdoc must include information on the patient, type of cancer, treatment received, and other relevant details.

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