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PERINATAL CONSULTATION CLINIC REFERRAL UR Medicine Perinatal Consultation Clinic (PCC) 125 Baltimore Road, Suite 150, Rochester, NY 14642 Phone: (585) 2757604 Fax: (585) 2428707PATIENT: Name: ___
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Information such as the name of the provider or organization, contact information, services offered, and location must be reported.
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