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FAX REFERRAL FORM (PLEASE CIRCLE PREFERRED LOCATION AND FAX FORM) Lees Summit Medical Center 2000 SE Blue Parkway, # 240 Lees Summit, MO 64063 Scheduling: 816.282.5915 Fax: 816.282.5808Centerpoint
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Please circle preferred location refers to indicating a specific location by circling it on a form or document.
Any individual or entity filling out a form or document that requires indicating a preferred location.
Simply circle the preferred location provided on the form or document.
The purpose is to clearly indicate the preferred location for a specific item or action.
The specific location that is preferred or selected by circling it on the form or document.
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