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JURISDICTION 6 MEDICARE CONTRACT INSTRUCTIONS (SMIL0 SMMN0 SMWI0) Please carefully read all instructions before beginning. Please FAX or Email all pages of your completed and signed forms to: MD On-Line
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Do not fax your is a form that is used to indicate that you do not want to receive faxes.
Anyone who wants to opt out of receiving faxes is required to file a do not fax form.
To fill out a do not fax form, simply provide your contact information and sign the form to indicate your request.
The purpose of do not fax your is to stop receiving unwanted faxes or promotional materials.
The information required on a do not fax form includes your name, address, phone number, and fax number.
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