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*Name
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Please list in preferred order & indicate if we should only use home number after a certain time.
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1st Please select one: HomeCellSMS TextSecure Message
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2nd Please select one: HomeCellSMS TextSecure Message
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3rd Please select one: HomeCellSMS TextSecure Message
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4th: Other
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AlphaNumaric
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Service # or Callers #
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Pager Company:
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All Medical CallsEmergencyRefillsLabs
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If Emergency Calls Only then please define emergency below:
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Consults
(Relay as they come in or relay until a certain time then hold next day consults for call out at what time)
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Additional Special Instructions:
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Are You Available For Non PTS After Hours:
YesNo
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Spam Protection: *
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