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* 1. Please enter your contact information:

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* 2. Please provide your thoughts and comments related to your overall experience with HealthLinx:

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* 3. HealthLinx has my permission to use my responses for testimonial purposes.

Testimonial purposes may include for future potential clients, published (including photographs and images, if any) in any type of advertising, publicity, promotion and other trade purposes for HealthLinx' products, solutions, and services. Permission includes use of name, title and company name unless chosen differently below. Note: there is no monetary compensation for use of a testimonial. Statements may be summarized or shortened as needed. In the event that a company logo is featured with my statement, HealthLinx will follow organizational branding guidelines in order to also promote the organization where appropriate.

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