External Information

Please complete this form for basic updates for your clinic.  We will publish information on this page. Information on the next page will not be published.

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* 1. Clinic Name

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* 2. Address

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* 3. What type of RHC are you?

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* 4. Clinic Administrator

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* 5. Name and title of primary care providers (Physicians, APRNs, etc)

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* 6. What type of clinical services do you offer?

Clinic Photo
As we make your clinic's biographical information public, we would like to include a photo of your clinic.  Please e-mail a photo to president@mississippirural.org.  This will be searchable by patients to help give your clinic additional exposure.

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