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WEB Current Patient Communicate - v2

Page One

The completed form will be emailed to a clinician at Gateway. As with all electronic communications, email is inherently insecure. If you want to guarantee the security of your message, please install a secure email service, like Virtru, and email us at
Please complete this form if you have a general question. For questions related to financial, scheduling, or medication, please refer back to the Online Office and click the appropriate icon. Thank you.
Contact information
(We are able to respond more quickly via email.)