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Migraine Treatment Center Materials Request Form

For Medical Professionals: We are happy to provide your office, free of charge, with patient information cards about the Migraine Treatment Center.

To request a supply of cards, simply complete the form below. Please order in multiples of 25, and note that orders require 7-10 business days for processing and delivery.

Name of organization to which you'd like materials sent:
To whose attention would you like materials sent?
Street address:
City:
State:
Zip Code:
Quantity of Migraine Center Information Cards:
Your email (in case we need to contact you):

Migraine Treatment Center Materials Request Form

Convenient Rochester Locations

Artemis Health

Folsom Health Center

Greece Health Center

Irondequoit

Perinton Health Center

Westfall Pediatrics

Wilson Health Center